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Should I Get One?

Discussion in 'Insulin Pump Forum' started by type1gabs, Aug 8, 2018.

  1. type1gabs

    type1gabs Type 1 · Member

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    Hi everyone

    I have been a type 1 for 24 years, im 25 so have lived with diabetes all my life. I had a couple of years previously that i was on burnout due to the stress of it all, but now im back in control and managing on novarapid and tresbia

    Im thinking of going on the pump, but would like some insight on what it is like living with one. Im apprehensive as im active (run and yoga), sometimes wear body suits/playsuits/tight clothing, like to go to the beach, and worried about being intimate with my boyfriend. Im also young so image is something important to me too but not too much of an issue.

    Also im wprried about knocking it/if its comfortable to wear etc.

    Any opinion or view is appreciated, itd br nice to get a real life view on it and if it is as good as it all seems
     
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  2. Juicyj

    Juicyj Type 1 · Moderator
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    Hi @type1gabs It's great that your thinking of going on the pump, personally I exercise alot more now using a Medtronic 640g, than I ever did before when I was on injections, simply because I can do a few things to help me exercise, so I can stick a temp basal pattern on the pump for the duration of exercise or if i'm only out exercising for 30 mins then I can take it off completely, which is also fine for more intimate moments too. I don't wear it for swimming as I prefer to take a correction afterwards if needed, I use a pump belt if I do wear the pump, it's lycra so stretches fine and sits around my middle, I also pull my lyrca shorts over it when I run so there is no movement at all and it's completely comfortable. I am personally not massively image conscious anymore so don't worry who sees it, it's more important to me that I am controlling my BG levels and not worrying about who's looking and no one has ever commented, so I doubt many have even noticed it. As your pump is using just novorapid for both bolus and basal it's easier to adjust on a pump for changes in activity levels.

    Bear in mind when you first start wearing a pump you will be very conscious of this, it does wear off I promise and sadly there is no way to disguise it unless you are ok with taking it off completely and using a libre or other CGM to monitor levels during exercise. Also just take a look around you, who doesn't wear a phone or other device when exercising now, it's more acceptable, using a pump would just look like an exercise device to others :)
     
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  3. Terrytiddy

    Terrytiddy Type 2 (in remission!) · Well-Known Member

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  4. Deleted Account

    Deleted Account · Guest

    I have had a pump for 2 years.
    It provides much better control than injections by allowing me to change the basal rate per hour (rather than per day) which really really helps with exercise. I run, cycle, climb, go to the gym, and have even used it on the flying trapeze.
    When in the shower, on the beach, being intimate, ... I take it off.
    I rarely knock it. It is usually comfortable. However, I am quite slim and boney so find it can feel a little when I clip it to my belt near my hip bone.
    People find all sorts of places to put it like in their bra, on a garter belt around their thigh or just clipped to a waistband or belt.
    It is possible for most people to find some way of hiding it.
    Unlike @Juicyj I have not yet got used to it being on display and there are some items of clothing where I just cannot hide it (like at the gym).
    Being slim and, like you, I like wearing tighter fitting clothes, a pump belt leaves a bump and being smaller in the chest department, if I put it in my bra, I would look very lopsided.

    If you are considering a pump there are other practical things worth considering like change the sets and inserting the cannula. This takes some time to get used to and I was very worried when I first started. But it is fine now.
    Setting up all the different basals can take some time. So, at the start, you should expect some ups and downs as you get the setting right for the time of day or type of exercise.
    Whilst I feel I have a lot less to carry with me when I go to the shops or a night out because I don't have to take my insulin pens, there is a lot more paraphernalia to take with me when I go on holiday as I need to take all the cannula insertion stuff and set changes.

    Overall, I think the pump is worth it. But my journey has not been smooth. Mostly, this is around aesthetics - I hate that I struggle to hide it so feel I am wearing a huge arrow saying "this girl has diabetes". Really, I know very few people notice and if I was larger, even less people would notice.

    Finally, if you are thinking of going for a pump, think about why you want/need it. Depending where you live, you may have to convince your local diabetes team that you are worth the investment. You will need to prove you can carb count and that you are willing to invest time into learning how the pump works as well as explaining how a pump will improve your diabetes management.

    Sorry, if my essay comes across as a bit negative. I want to be honest rather than sugar coat it. And the fact I have stuck with the pump even though it conflicts with my vanity, speaks volumes about the benefits it brings.
     
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  5. LooperCat

    LooperCat Type 1 · Expert

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    I’m very new to a pump, having only started last Thursday! I was on injections for a shade over 20 years.

    I’ve got the Omnipod, and so far I really like it. I was put off for years by the idea of tubing and a control unit clipped to me, but this one is completely tubeless and controlled wirelessly. The pod is 1.53 in x 2.05 in x 0.57 in (3.9 cm x 5.2 cm x 1.45 cm), stuck on pretty much anywhere you’d inject, and changed every three days. My current one is just where my hand brushes my leg when I’m walking, so I’ll know to avoid that spot in future! Husband says he hardly notices it, or my Libre/MiaoMiao combo on my arm.

    I got mine because I get quite bad dawn phenomenon and a fair bit of insulin resistance every month, which I wasn’t able to counter with MDI. I’ve done a fair bit of number crunching over the last few months in trying to get it sorted, so knew what my insulin sensitivity was at different times of day, and we were able to set up an initial basal programme that reflected that. My first 24 hours were great, I was in range about 90% of the day - and on day two the resistance kicked in and I quickly had to get a new programme to deal with it - talk about in at the deep end! I’d have liked a few days to get used to the thing first, but that’s exactly why I got it... I’m fiddling with the “shark week” programme at the moment - I had it all set a bit high yesterday, and was running a bit on the low side most of the day - but as well as taking dextrose tablets, it’s easy to reduce the basal rate for half an hour to let things come back up. That flexibility if you’re doing different things is brilliant.

    As I say, I’ve not had it a week yet, so haven’t been out for more than a few hours. It’s nice not to be injecting (although I have that odd feeling that I’ve forgotten something really important ;) ) in public, although that never really bothered me much. I’m going to be going away for a few days next week, so will of course need to take double the amount of pods I’ll actually need, and batteries for the remote. On a day to day basis, I carry a spare pod, vial of insulin (in case of a failure, so I can just pop a new one on), and a syringe in case I’m out of pods and need to do an injection, saves carrying a pen too - I may waste one by taking it out of the fridge for the month and never using it, but I’ve always got my little bottle of insulin.

    I don’t know what it’s like to change a cannula set, but for the Omnipod, you fill a new one with enough insulin to last three days, stick it on, and activate it using the remote control (which is a bit clunky but does the job). Once you hit the activate confirmation, you just pinch up the skin a little around it, and it automatically inserts the cannula. There’s a little inspection window so you can check it’s inserted properly. You can feel it going in, but it’s no worse than flicking your skin with your finger.

    Hope this helps!
     
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  6. Deleted Account

    Deleted Account · Guest

    I am trying my best not to be too jealous of you and your tubeylessness.
    I hope they become more prominent and accepted by more CCGs in England and Wales.
    I will keep my fingers crossed my local team see the value of it in the next 2 years when I am due for a change.

    I guess it is worth highlighting to @type1gabs of the pump postcode lottery - the decision on which pump to offer is made by your local CCG. Some give a full range of choice, some offer a few and some (like mine :arghh:), only offers one.
    Therefore, if you are thinking of getting a pump, it is worthwhile finding out what your options are in your area before setting your heart on a particular wonderful tubeless miracle.
     
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  7. LooperCat

    LooperCat Type 1 · Expert

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    Tubeylessness is now my new favourite word ;)

    Which pump do you use? I think my CCG only offers two options, the Omnipod and a Medtronic 670.
     
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  8. Deleted Account

    Deleted Account · Guest

    I have an Animas Vibe. This is no longer available as Animas have dropped out of the market.
    I think, currently, my CCG offers the Medtronic 640.
    They have 18 months to change their policy (or for me to change it for them) to include some tubeylessnessness when my Animas warranty expires.
     
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  9. LooperCat

    LooperCat Type 1 · Expert

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    Although with a tubeylessnesslessness one, you can’t take it off, ever.
     
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  10. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @type1gabs, You (and your parents) are stars for navigating 20 years on the river of life with diabetes. Congrats!
    At the 45 year mark on insulin I was having trouble with night hypos with 8 injections per day. Being prescribed an insulin pump saved me from the terror of those hypos, enabled me to keep my driver's license and employment, improved my HBA1C's no end.
    Now 7 years later I could not go back to injections. Sheer stubbornness to remain as independent as possible is now ended!
    From what I can gather very few but some diabetics cannot tolerate or adapt to insulin pumps.
    Each brand of pump has its pluses and minuses, mainly to do with tube vs tubeless, alarms and Medtronic with its dose reduction feature (the Continuous Glucose Monitoring, CGM feature which alerts the pump to a low BSL and triggers a go-slow on the basal program of insulin), size, and whether a remote control is a plus (convenience) or minus (what if it is lost ?).
    Where the pump shines for me is as others have said, programming for exercise AND for stress (exciting movies can put my BSLs up !), after a influenza vaccination my basal and bolus dosing goes up 30% plus for about 4 days. Much, much easier to handle that way than trying to do so with MDI ( long-acting insulin, plus short-acting before meals) Being a guy, I leave how cycles can be handled to others. For a 'slow carb' meal like some Indian and Italian cuisine (where BSL rise may peak at 3 instead of 2 hours, the split combo feature of the pump (e.g. options to do 20 -50% at meal and obverse say 1 or 2 hours later. And the Dawn Phenomenon is managed by programmed basal rather than upping long-acting insulin and ending up hypo etc.
    Downsides: 1) the needle insert procedure which leaves a plastic cannula through to under the skin can go in bent, or become bent or detach enough to allow insulin to slowly leak under the sticky patch leading to diminished insulin delivery and otherwise unexplained high BSLs (unfortunately this restriction of insulin supply does not trigger an alarm except maybe if you are using CGM)) and this raises the next point: The reserve of insulin is stored in the pump, compared to your current insulin regime where long-acting insulin is stored in your body for ? 12 ? 24 hours after each injection. The short-acting insulin used in the pump wears off in ? 4 to 6 hours, so with reduced or no insulin input via pump ketones show up pretty quickly.
    2) if the battery cap loses connection, the battery no longer powers the pump and as every alarm works off battery power you will be unaware that the pump is not delivering insulin until you check a BSL (and the CGM will not be working either to alarm about high BSL) ( I am unsure if this applies to the pump powered by body heat )
    3) with exercise, the sweatiness may cause the needle insert to detach, and thus it may be only when the CGM, if in use, may alert you to the fact that no insulin is being delivered under the skin.
    4) not only is the pump a 'potential threat' to fashion, one needs to consider for any outing taking along spare needle insert, reservoir, batteries, insulin, and pens with short and long-acting insulin to cover the need to change the reservoir, cover low battery alarm, and failure of the pump with need to revert to short-and long-acting insulin. Some countries have agreements to provide a spare pump in case of pump failure but not all and some have had hassles at airports as the pump is not to go through luggage strength scanning. Of course a pump would need to be removed for medical imaging.
    Redeeming points: You still need to be taking spare insulin pens and glucose meter along with your current insulin regime; pump failure is rare; you adapt by learning to automatically check the needle insert; handle the potential tube tangles, either check CGM or do check of BSL with meter to look for trends. What I love are the accessories for pumps, whether you buy a commercial one or re-purpose a travel wallet etc. I turn my pyjama shirt inside out and use the now inner pocket to house my tubey pump at night.
    My daughters in law joke about fashion bum bags to carry a pump, fake hip pads to balance out an insulin pump worn on a belt/hip area, same for the bra area (Modesty prevents me from explaining further !!) And the piece de resistance for me happens to be an accessory from Medtronic (i do not use their pump) the soft toy lion !! At age 64 (yeah, the Beatles song and all that) I could almost get away with carrying a soft toy lion or similar around.
    Best Wishes on your deliberations, from a biased pumper (in his jumper in Australia)!
     
  11. Deleted Account

    Deleted Account · Guest

    I think this has been discussed before but I wanted to mention that I only take all this paraphenalia if I go away for a night.
    If I am away for a few hours, I just take a syringe. My pump has failed once in two years and I used the insulin in the pump with my syringe every hour to keep my BG level(ish).
    No need for the spare needle insert, reservoir, battery, pens, ... and a handbag that looks more like a suitcase to carry it all in.
     
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  12. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Hi!

    I've had a pump for 3+ years. I'm active, work in acute mental health setting, do mountain biking and have 2 small kids who love rough play. I've just switched to a new pump with CGM and last night I signed up for muay thai and brazilian jiu jitsu classes. I live in Australia and we're always at the beach. The pump has not stopped me doing anything. Yes, I'm aware it's there, but life goes on. Having had the new pump for a week now, my control and levels are fantastic and I am now a huge advocate for CGM and pump therapy.

    Even with extreme physical activity, it doesn't get in the way. My online buddy, Kevin Kellerman fights in UFC and has a pump and insulin - he trains MMA 6 days a week.

    You got this!
     
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  13. Juicyj

    Juicyj Type 1 · Moderator
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    Hi - I don't have my pump on show ever, I wear skinny jeans and t-shirts alot so it may be visible if someone was to fixate on me and see a bump, but as it sits around my middle alongside my belt it's not exactly noticeable, if I wear a dress I either strap my pump with a pump belt folded twice to the top of my leg with the pump on the inside or tucked into the front of my bra, either way it's not visible then either. My point is that even if the 1 in 1000 person did spot it, then to be honest I couldn't give a hoot, and if they're curious to ask then i'd be happy to fill them in on it.
     
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  14. richyb

    richyb Type 1 · Well-Known Member

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    I been type 1 for 53 years. Only been pumping for 18 months. A big advantage is, if you want to alter basal rate with tresiba it takes 3 day's to see effect. With pump it's a few hours. I used tresiba the pump is very good for me. When going out for meal just dial in the carbs and press go, or extend the bolus for slower acting food. A pump though is not easy to manage its as good as the settings that the user puts into it.
     
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  15. Tonto73

    Tonto73 · Member

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    Pumps are great if you set the
    up correctly. Read Pumping Insulin - you can find it for Kindle or order online. It gives you all the insight you need to know. Other comments are correct - you do need to work at it to get the best out of it but once your there it’s a game changer.
     
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  16. Chowie

    Chowie Type 1 · Well-Known Member

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    Go for it. I have only been on a pump for 6 months and my HbA1c came down from 8.3% - 6.8% (67-51) and it was still being adjusted. I was concerned sleeping with it and being tied to it - not a problem. You can disconnect it for 30 or so min, so it won't restrict any activities. I only have one very big regret and that is I didn't do it sooner.
     
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