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Ready to quit pump use

I think there are certain criteria you have to meet, and your consultant or GP can put you forward to be considered for a pump to be funded for you.

Otherwise you can pay privately to have one, but they are quite expensive (around £2000 for the pump itself and about £1500 a year for consumables, I read somewhere).
 
Weird to see I'd posted on this old thread before. I'm back aagin now because, for the first time ever, I'm seriously considering stopping using my pump

I'd been using my thighs as a site for 5 months and then they stopped working, which is perfectly normal as I always swap sites after 4-6 months BUT when I tried swapping to my bum last weekend NONE of the cannulas have 'taken' properly. I've had day after day of highs and it's really wearing me down physically and mentally. Not only that, the Humalog pen i use for correction doses is struggling to bring my BS down. I did a test after breakfast and my BS was 10.00 so I had a correction dose, but, 3 hours later, it was still 9.9. So yet again, I had s*d-all lunch because that's too high to have any carbs. I feel I've been made to starve all week because of my stupid high BS. I'm slim anyway and definitely need to eat plenty of food.

I really can't get across my total and utter FRUSTRATION. I can cope with the sets, the needles, the frequent blood tests, etc - all of the pump stuff as long as it works. What I can't cope with is high BSs and no way to bring them down properly. Yes, I imagine this is because the basal insulin isn't being absorbed properly from my bum, but I have nowhere else to put the sites. I can't use my tummy as no area on that seems to work at all now (I haven't used it for at least 5 years for that reason) and obviously I can't use my legs as that's the area that's just stopped working.

I feel like I'm totally stuck

Any help, and advice would be very, very welcome. Anyone, please?

I originally went on the pump 10 years ago because I was having awful night time hypos so I would be very nervous about going back on long-acting insulin. Also, my Dr is total rubbish and doesn't listen at all or really know much about diabetes, and it takes an age to get an appointment to see my consultant. I'm completely fed up with my pump this week
 
Hi Azure, you might find the solution is to use a different cannula length and also think about doing a basal test, as many find they need more insulin when using bum for cannula's
 
you should try going onto an omnipod pump. No tubes, cannulas or anything like that.
Also, you wont run out of places to wear the pod. You can use your triceps, back, chest, abs, legs, calves.... infact Ive seen people wearing them on almost every body part.
 

The Omnipod is a cannula with a reservoir attached to it. https://www.myomnipod.com/about-omnipod/system-overview/ it doesn't matter what system you use as long as your basal is right for the body part being infused. Bums most people find just need more insulin.
 
i had the accucheck before. switched to omnipod. they are very different. the cannula self inserts and is much shorter than the accu check or medtronic.
 
Omnipod said:
i had the accucheck before. switched to omnipod. they are very different. the cannula self inserts and is much shorter than the accu check or medtronic.
Click to expand...

Many of the cannulas for the tubed pumps are self inserts and as the pod is a 6.5mm cannula it's bigger than most as most start at 6 with one at least having a 4mm cannula.
 
Thank you for replying, CarbsRok and Omnipod - very much appreciated.

I've used my bum before and, yes, I do use a longer cannula there (17mm instead of 13mm) and I increase my basal rates too, which I have done this time. But the issue seems to be that wherever I put the cannula, the insulin isn't absorbing properly at all. I' don't think it's anything to do with basal rates as I've even increased them from my normal bum rate and it hadn't made any difference.

I'm doing correction boluses with my pen but even those aren't working as they should because I'm having to do them in my leg and that was the place I last used as my pump site. I've also tried my arm but that seems to be hit and miss as to whether it absorbs properly or not. I've also changed every bit of my pump set and insulin, and done the same for my pen too.

I'm as sure as I can be that it's something to do with absorption. It panics me quite a bit as I feel like I'm going to run out of places to stick cannulas and pen injections, and then what on earth do I do?

Omnipod - I've read about the Omnipod but I never tried it as it looked quite big (I'm quite petite) and I thought I'd be bashing it all the time. I use Accucheck Tendlerlink sets, by the way. I only have the two lengths of cannulas that I mentioned above.

I've just tried putting a site in my back, kind of at the side just above my waist, but my blood sugars are still 10. I wsnt completely sure what angle to put it in at as I couldn't really see how it'd absorb properly. I imagined the cannula would be pushed too flat.

Do either of you use the 'middle' of your bum for sites? I always thought you were suppose to use the narrow strip above your pants, but now I'm ready to try anywhere I've not used before and I wondered whether lower down would work?

And what about upper arms? Where do you put the site (inner arm, outer, underneath, on top?) and do you point the cannula down the arm towards the elbow or up towards the shoulder?

Thank you again for replying. I'm really grateful that you took the time. There's nothing as miserable as day after day of ****** blood sugars.
 
azure, the Omnipod is really small. its much easier to hide than a pump and tubing. I had asbsorption problems when I was on the accu check and the medtronic. I was limited to areas where I could wear the canula and as a result had these hard lumpy areas - that cause the absorbtion to slow down.
I mainly use the top of my thighs or triceps.

Are you doing any excercise? Excercise does help. Your body becomes more sensitive to insulin.

Perhaps you need to increase your basal by 25% for a couple of hours when changing the canula? Diabetes is just one of those conditions where you constantly need to keep adjusting your insulin doses.

I dont think your issues are about the pump itself. No matter what treatment we are on, these issues are all the same for everyone and it does get harder to control the longer we have the condition.
Everyday is different. Just keep testing and try stay on top. Whats your carb intake like? Are you low carbing?
 

Thank you - that's interesting that you had problems on your previous pumps too.

My experiment with putting the cannula in my back was a total failure. My blood sugar in the night was 14, which is unheard of for me. It's now down to 10.4 after some Humalog from my pen but obviously that's not good either (although it's a hell of a lot better than how I felt at 14)..

I think what's so frustrating is when sites 'run out'. I'd been using my leg fine for a few months, rotating sites carefully, and my blood sugars were lovely. Not a moment's trouble. Then they started to go higher so I changed to my bum but I just can't seem to find any area there where the insulin's absorbed. I've had similar problems in the past swapping areas but it's only taken me a few days to discover where the cannula works best, and then I've been fine.

I've had diabetes for 20yrs and it's only in recent years I've realised that control is never sorted. When I first got diabetes, I had no idea at all about absorption problems. I naively assumed that if you did everything right, you just kept on going doing what you were doing.

What you said about being able to put the Omnipod in more places does make it sound good. I think that's what I need - more sites I can use. That's why I was thinking about going back on MDI - I thought I'd be able to inject in places where I couldn't put a pump cannula.

Yes, I do exercise - or rather, I keep active all the time. I do a lot of walking, and I always stay active after meals. I don't do any formal exercise, just walking and rushing about. It's interesting that you mentioned low carbing. I've been interested in that and reading stuff online. Ironically, I just ordered a LCHF recipe book last week. This last week I've been low carbing simply because my blood sugars have been so bad. But before this latest mess-up with absorption, I ate approx 150g of carbs a day. I'm quite slim so I worry about losing weight if my carbs go too low.

Do you low carb? Do you think it helps because you're having less insulin so your sites don't get so bad? Was it poor absorption that made you swap to the Omnipod? And are you in the UK? I've never seen anyone with an Omnipod here. My clinic seems to use Accuchek for everyone.

Sorry for all the questions. I hate not being in control of my diabetes. It's beyond frustrating.
 
Azure, the beauty of using the Accu chek and Animas pumps is that they both have cartridges that accept the standard Luer connecting tubes and will fit an assortment of different infusion sets supplied by either company.

Have you tried using Animas sets at all just to see if the absorbtion issue is the same? Also, have you tried using the 90 degree steel needle set like the Rapid D and inserted it at the back of the arm or gone completely to the centre area at the top of your backside?
 

Thank you for replying, iHs.

No, I've never tried any different infusion sets but I think I'll have a look online now. My pump is an Accu Chek D-Tron Plus (yes, really : D I like the way it takes normal pen cartridges and so I've stuck with it). My pump is funded by the NHS so when I order new sets and cannulas, I just phone up and order them and the bill is sent to my local PCT. I'm not sure how that'd work if I got Animas sets?

I'm going to look at the Rapid D set now. Stupid question but when you say "the back of the arm" where exactly do you mean? The underneath or the bit on the outside of your arm running up from the elbow bone?

As far as my bum goes, I've used a strip running from just inside my hips (I've never got good absorption too close to them) to the middle but, again, if I go too close to the middle ( near my tailbone but lower) I find the absorption starts to drop a bit. Even in the past when my bum worked ok, there seemed to be some 'bad' spots.
 
I used my bum for nigh on 30 years.... No problems.

I cannot use flexible cannulas, as I am too lean and muscly. Rapid d 6mm's in my bum are pretty much spot on. Had a few issues with one batch of sets recently and as my pump wasn't alarming for 10-12 hours they have swopped sets and pump.

I would try rapid d's.
 

The Rapid D is just a 6 or 8mm steel insulin pen needle stuck at a right angle onto a piece of sticky adhesive. Its easy to insert and prime as well. I stuck mine in the top centre of my backside (where no insulin pen went)) and just made sure that the adhesive was stuck down well. In the arms, I just used a part that had a tiny amount of 'flab' and inserted there. Good place for me was at the top towards the back part of arm towards armpit. I sometimes use an insulin pen with 4mm needle and can still inject in the same area on my arms as I did for about 40 plus years with no absorbtion trouble.

Try the Rapid D first and if that doesnt work try the Flexlink with the inserter. You may be surprised.....
 
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Thank you both so much for the advice. I keep saying I appreciate it but I really, really do.

I've ordered boxes of Rapid D sets with a 6mm cannula and I hope they'll be here very soon : )

I'm speaking to my DSN tomorrow as apparently I need 'training' before using a new type of set. Hmm. As long as they can organise that quickly so I can give the Rapid D a go, then I don't care. I'm really starting to think my Tenderlinks are contributing to the problem partly as the last one I took out had a bit of a bent cannula. I'm willing to try anything to get my control back.

Fingers crossed!
 
Do you low carb? Do you think it helps because you're having less insulin so your sites don't get so bad? Was it poor absorption that made you swap to the Omnipod? And are you in the UK? I've never seen anyone with an Omnipod here. My clinic seems to use Accuchek for everyone.

I do low carb. I find it helps keep my blood sugar more stable. Stable blood sugars = good weight. Eating protein will help keep the weight on too.

Poor absorption and lack of areas to wear the pump made me change. Since I been on the Omnipod (1 year this month) I have never experienced any problems.
I am in London.
Some hospitals do not push the omnipod because they dont have staff trained up on the omnipod and or, they cant be bothered to help patients apply for funding. St Mary's Hospital and Chelsea Westminster are pro omnipod.
 
Hi

Did you order a box of tubes as well for the rapid d's?

They have different connectors.

The rapid d's you prime before putting them in. Which is nice as you can assure yourself that the needle is working and that you haven't under or overprimed when you have to do it in you with the teflon ones....

My rule is because I am lean and muscly that "if set hurts, it won't work". Thats why I use my jlo bum as thats the most fat and I very rarely get pain. Did last week from the set feeling like it was hitting my hip bone when I lay on it. Normally bum totally ok, but too near to my hips cos there not alot of fat there I can occasionally think set been good all day, lie on it and I can feel it... So I know it not going to be good.
Normally instances like that are very rare.

Rapid d's are tiny needles and so easy to put in. I can't use them in my stomach or arms, as they do hit muscle. My legs seem to spurt a lot of blood so not good either.
 
My dsn told me to look at utube for training when I considered your sets!!! That training comment really made me chuckle after what mine told me!!-lol.

Never did change to yours and stayed with rapid d's!
 

Thank you for that link - perfect : )

Accu Chek wouldn't send out the sets unless I organised training. I suppose it's to cover themselves, but if I was that stupid I'd have killed myself off with a way out carb/insulin calculation a long time ago or any other daft thing that I could, in theory, do without 'being trained' on every aspect of pump use.
 
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