Pump benefits?

Pumps can match your basal requirements. It gives you different amount of insulin at different times of the day. That's the main advantage of having a pump, and because of that its generally easier to sustain good control. For me also a possibility of running temporary basal rates is important (its when you can reduce the basal for shorter period of time). Its incredibly useful for gym or long walks

The main benefit for me is flexibility, as Ewelina says. Managing dawn phenomenon by applying higher basals for short periods of time while asleep is the biggest benefit.

If I'm honest though, my Hba1C was reduced from 7.2% to 5.9% using the Libre. With the pump in trying to reduce my variability.


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GrantGam1337 said:

Apart from fewer injections, what are/isn't the benefits of a pump?

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The bolus options above all else, having the ability to use features like a Dual-Wave bolus so that you can bolus part of your insulin dose upfront and extend the remainder of the dose over many hours is a big plus, this is especially useful when eating difficult meals like those that are high in fat which might have meant 2-3 injections for one meal.

Also like the basal delivery and getting to use a TBR (temporary basal rate) in times of illness and exercise, there's many more but don't want to go on, the only negative is you do have to be more vigilant and test regular to look for any problems that may be developing.

The ability to sugar surf with micro dosing has been the game changer for me. I can micro manage the pesky peaks and troughs I became aware of with CGM, with little or no effort. The whole thing is made much easier when paired with CGM/GM (which I believe you are not overly impressed with) so can be done with standard finger pricks, but that just takes a lot more effort I can imagine. I think with everything in diabetes, it works for some people, it doesn't for others, but for me, it has been amazing. After 30 years, the injects are no longer a chore before I eat, get up and go to bed. Those, albeit minor, irritations and breaks in the flow of the day, are no more.

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I'm not a pump user, but may want to be so interested in this thread.

I was thinking about pumps, as an example, one night I could go to bed at 7.1 and wake up at 12.9 another night go to bed around the same 7 mark and wake up on a 4 - setting a 'standard' basal rate could fail spectacularly either way for those nights, so how would a pump help?

(I think but correct me if I'm wrong, that my varied examples are as a result of differing food behaviours, and so I'd learn how to bolus for those more accurately with a pump and so flatten the peaks and troughs and even out the variances?)

slip said:

I think but correct me if I'm wrong, that my varied examples are as a result of differing food behaviours, and so I'd learn how to bolus for those more accurately with a pump and so flatten the peaks and troughs and even out the variances?

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This is one of those cases where you'd have to monitor and record what you were eating, when and the effect it has on you. Once you'd done that you'd look at whether the bolus options on a pump might help you. But until you do the observation and comprehension of what's going on, a pump won't automagically help. The technology is only as good as its user!

GrantGam1337 said:

Thanks for all the input guys! Sounds like pumping has few (if any) draw backs.

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If you are starting to consider a pump, the book Pumping Insulin (5th ed.) is brilliant, and worth starting before getting one, simply because it gives you an idea of things to consider and prepare before making some of the decisions. Sugar Surfing and Think Like a Pancreas are also excellent books, as they give great insight into exploiting the features of pumps.

GrantGam1337 said:

Thanks for all the input guys! Sounds like pumping has few (if any) draw backs.

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I wouldn't say it doesn't have any drawbacks Grant, only last year there was two members on here who give back their pumps and went back to MDI.

What helps IMHO is reading up about them beforehand, the books that @paulliljeros has mentioned to you is a great start, even 17 months on I still refer back to Pumping Insulin when unsure of anything.

the major drawback for me - called the 'achilles heel' of pump therapy in a scientific paper - is the infusion set. i could never use the non metal sets but found the metal sets fine for many years, but more recently i have found my body starts rejecting the infusion needles, the skin has had so many infusion sets in over the years that it seems it cant take any more - the set sites get more and more sore, and there is intense pain when i take out a set and more likely than not, bleeding - both used to be rare. I can hardly believe that i used to forget sets were in sometimes. I am soldering on, changing sets when this happens, in the hope this is temporary, as the advantages are less hypos and - most of all - nights, as i use so little insulin then, and pumps can fine tune this and a morning rise. If i did not use such varying insulin, and was not so insulin sensitive, and did not have a history of hypo problems i would not be on the pump now. They are great short term, but after very many years - not so sure, at least that is my experience. I have always had very thin, sensitive skin, and a small weight loss has left even less areas suitable for sites - it might be different for others

I am a relatively new pumper. Like GrantGram1337, I was not sure what the benefits were. After 4 months, I see pros and cons:
Pros
- Ability to adjust basal. These words meant very little to me when I first read them and I still think they are too scientific. Basically, the basal injection assume your body uses the same amount of background insulin 24 hours a day. However, this is not the case: at night when lying still, you need more insulin and during the day, especially when exercising, you need less. This has helped me at the gym and climbing significantly.
- Ability to "program" bolus dose over a longer period. When on injections, if I ate something which took a long time to digest (e.g. pizza), I would have to take multiple injections; with the pump, I can tell it to give me 50% now and 50% over the next 2 hours, say.
- Less "stuff" to carry to take out for a night. I no longer have to remember to take my pens with me as my insulin is connected. I still take my meter and dextrose but with only a few test strips, this is much easier. And, if I pop out for a quick drink, I can change my mind and have dinner too (before I used to go out without my insulin).
Cons
- It's bulky. This seems to be less of a problem for most people but having a small frame and being image conscious, I really dislike the "pack of cards sized bulge" in my clothing. There are options to hide it but these make it difficult to access when I need to bolus.
- Way more "stuff" to take on holiday. In the past, I used to sit on the floor counting needles before I went on holiday. If I did not have diabetes, I would not have to do this but, at least the needles took up little space. Now I have to take needles and pens, just in case, as well as lots of paraphernalia to change the canula every 2 - 3 days. For a week long holiday, this is a small carrier bag full which has to go in hand luggage.
- The pump cannot be x-rayed. So what, you may say. Well, since I had the pump (4 months), I have been on half a dozen flights and each time, I have to explain that I do not have something in my pocket: it is a pump which cannot go through the x-ray machine. This means, it cannot go through the body scanner (but ok through the "arch"). In my, limited, experience, the UK security guys recognise this and are very considerate. The US security are less so: they will not touch the pump and, instead, have to do a full body pat-down.
- The canula. This is the bit that is always attached and, being slim, I find it can be painful to attach. I have the ones that go in at an angle so they do not go so deep. However, they can still hurt. And they are a faff to change every 2 days (In theory, they could last 3 days but it hurts too much after 2 days for me).
- The pump is ugly and fiddly. I am an engineer so I don't have any problems controlling the pump. However, the user interface was designed about the same time as Nokia was designing their first phones ... except the pump doesn't even have a number pad.

Overall, I am sticking with the pump because of the benefits it gives me during exercise. However, it has not transformed my life.

I agree with much of the above - the pump is bulky, and for slimmer women or young people it is not very easy to hide. I think, in another thread, some slimmer women also said they found the sets painful. Even the smaller cartridges are much too large for just 2 or 3 days supply, unless some users use a lot of insulin.

As a 6'5" 14.5 stone guy though, a pump isn't that big!

3ml cartridges last me a week as well. Apparently the larger cartridges are mostly designed for use with T2s that are very insulin resistant.


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for me it has reduced amount and severity of hypos--which is life changing for normal everyday living ( just ask my wife )

I've not had many notifications of updates on this thread either, both via full blown site and app - I only knew about an update when someone agreed with a post of mine or was quoted. Not sure if the forum is having technical difficulties?!

Edit: Tagged @GrantGam1337 just in case!

I'll tag @Giverny who may be able to answer your questions.