Start towards a pump.

I know the feeling! I've just been through the process and yesterday was given my pump. This week it is with saline and then I go live with insulin next week. The training was really intense and sooooo many things to learn and work out. My reason too is for dawn phenomenon and my libre data showed that 16% of my time was spent hypoglycaemic. Anyway, I was warned that things are like to get worse before they get better, but the improvement will be life changing. I'm too, fairly new to carb counting.
It is totally overwhelming, but if you want to go for it, then don't let anxiety get in the way. My husband came to the training too, which helped him to understand it better.
Another thing they gave me was a quality of life questionnaire which made me feel so much more normal. It highlighted all the thoughts and feelings that diabetic people can have that can consume their life. I left feeling positive.
I hope you have the strength and support to make the right decision for you (whatever that may be)

Hey @jimmysmith Out of interest what have you read that's made you feel this way ?

If you want it then go for it, and don't doubt your decision, I know that my pump has changed my control in so many ways, less hypos and also I rarely drop below 3 now, less anxious as I'm not injecting all the time and do a cannula change every 2 days, control in general has improved greatly, I am in touch with my DSN twice a month to review, it took a good 4-6 months to really start to appreciate the benefits and settle into my ratios which still needed the odd tweak here and there, flexibility with exercise.

Honestly just stay positive and stick with it, it will improve your DP situation and there are so many other benefits too.

jimmysmith said:

The amount of stuff that seems needed, supplies and calculations etc, it just....got to me i guess

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I was overwhelmed to start with, and it really was hard work in the initial stages - but it has all become second nature to me. I've had a pump for 2 years (out of 31 with diabetes) and I wish wish wish I'd had it sooner - it's given me such confidence.

I did so so much research and reading that my head spun! But I'm so glad I gave the pump a go. I love my pump and what it brings to my life.

Don't be disheartened. Read all you can, and take each day at a time when you start pumping. Before long I'm sure you'll find all the 'stuff' becomes just a part of the routine of life, like brushing your teeth, washing your hair, going to Tescos.......

@Snapsy spot on - it all becomes second nature. @jimmysmith you’ve already started on the hard work it all makes sense when your wearing it and have had your training, don’t be put off.

I too moved to a pump primarily due to dawn effect and the impact it was having on me trying to control it, best move I ever made. The first few months need a fair bit of effort, as mentioned above but you'll soon forget about this.

As people have stated already it does take a lot of work initially, the rates that have to be run, basal rates and the like, but all that hard work that you put in is so worth it, I never realised just how unwell I felt prior to going on a pump, I can truthfully say it has been life changing (bit dramatic I know), no more injections, you will always carb count, test and the like anyway, every thing that comes with the pump becomes the norm. set changes every two days, piece of cake. If you feel that its what you want @jimmysmith then go for it!!! it is the best thing that has happened to me in 22yrs being a diabetic, don't let it put you off or become overwhelmed, my DNS was there every step of the way, and still are, just go for it. Good luck!!!

Once the pump is set up for you (which takes some trial and error), it is then up to you how many of the features you use.
My pump motivation is different to many: it is to be able to exercise without my BG plummeting or rocketing (depending what exercise I am doing). As a result, I use the temporary basal at least every other day but I suspect many people don't bother with it at all.
I have also found that I need to be more accurate with my carb counting. But that is not a bad thing. When I am out, I still guestimate the carb content in food. If I am unsure, I tend to under estimate - a pump is s much easier to do correction doses when I get it wrong.
As others like @johnpol say, set changes become second nature and the pump just feel like normal.

Initially, I was unsure until I was told I could go back onto injections if I didn't like the pump. It is not a one way journey so I would recommend giving it a go. Not many people go back but the safety net is there.

helensaramay said:

it is to be able to exercise without my BG plummeting or rocketing (depending what exercise I am doing). As a result, I use the temporary basal at least every other day but I suspect many people don't bother with it at all.
I have also found that I need to be more accurate with my carb counting. But that is not a bad thing. When I am out, I still guestimate the carb content in food. If I am unsure, I tend to under estimate - a pump is s much easier to do correction doses when I get it wrong.

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Same here, @helensaramay ! Temp basals all the way - yesterday I swam, biked AND ran, and today gymmed and swam - I'm trigger happy on TBRs and managing pretty well most of the time to avoid hypos and post-exercise highs thanks to some button-pressing.

Actually it was only when I started pumping that I even dreamed of ever running. Talk about a new-lifestyle facilitator!

(Thanks to using a Libre I can see hypos coming, so will often set a TBR to ease the rate of drop.)

I had forgot to mention the Temp Basal rates!!! use them all the time, especially when preparing for competitions, best things ever!!! thanks @helensaramay and @Snapsy for reminding me, like I have said before, pumps aren't for everyone, but life altering for me!!!

johnpol said:

I had forgot to mention the Temp Basal rates!!! use them all the time, especially when preparing for competitions, best things ever!!! thanks @helensaramay and @Snapsy for reminding me, like I have said before, pumps aren't for everyone, but life altering for me!!!

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I had no idea, before I started pumping, how much I was having to 'feed' excess insulin with carbs. Because of course once insulin's in you, you can't take it out if you, say, fancy a spontaneous run/bike ride/extended roll in the hay..... *coughs*

What I love about pumping is that I can be so much more spontaneous, and turn my basal down - or off! - and that way avoid hypos or finding I need to be eating doughnuts* just to keep going.

Having the ability to control basal rates at the push of the button does allow for 'taking insulin out' - I view it as turning the tap down, or off. It took practice to start with, and confidence, but it has been a real (and positive) exercise of trial and error.



*other snack foods are available

Snapsy said:

I had no idea, before I started pumping, how much I was having to 'feed' excess insulin with carbs. Because of course once insulin's in you, you can't take it out if you, say, fancy a spontaneous run/bike ride/extended roll in the hay..... *coughs*

What I love about pumping is that I can be so much more spontaneous, and turn my basal down - or off! - and that way avoid hypos or finding I need to be eating doughnuts* just to keep going.

Having the ability to control basal rates at the push of the button does allow for 'taking insulin out' - I view it as turning the tap down, or off. It took practice to start with, and confidence, but it has been a real (and positive) exercise of trial and error.



*other snack foods are available

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Yes I find it a brilliant way for controlling what I want to do, with daily injections when I was competing all those years ago(back in my youth, when I was windswept and interesting) I found myself in trouble too many times, especially with too much insulin on board for what I wanted, or planned to do. having the pump means like you say I can turn it off if I need to. absolutely love it, especially with my five in the morning cardio sessions....................on the treadmill. mind you have forgotten what an extended roll in the hay feels like!!!!!!!(been married toooooooooo looooooooong happily I may add!!!!!!!)

Like @jimmysmith it's often been suggested that I get a pump as I sometimes have hypos out on the hill with the dogs (and I work a few night shifts a month which can be a pain). What puts me right off is having something so bulky permanently attached. I've been Type 1 for 40 years and (at least I think) have always managed my diabetes fine with an HBA1C between 6 and 7 for years. Can anyone tell me honestly if the alien thing always being there isn't a bit hellish or do you get used to it?

fmacd said:

Like @jimmysmith it's often been suggested that I get a pump as I sometimes have hypos out on the hill with the dogs (and I work a few night shifts a month which can be a pain). What puts me right off is having something so bulky permanently attached. I've been Type 1 for 40 years and (at least I think) have always managed my diabetes fine with an HBA1C between 6 and 7 for years. Can anyone tell me honestly if the alien thing always being there isn't a bit hellish or do you get used to it?

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When first offered a pump I didn't want it because I didn't want something attached to me. The idea really turned me off. Then I started using a dexcom, which means having the sensor and the transmitter permanently attached. But it's much smaller than a pump. Maybe about the size of a thumb tip? Anyway, I didn't find having the dexcom anything close to a problem. It's never been a bother. The dexcom was to manage hypos and they were telling me I needed a pump to manage hypos so as I got on with the dexcom well I thought I should look a bit closer at a pump. I would recommend having a look at YouTube for real people wearing real pumps (and not being bothered by them) and if there's an opportunity to have a look at/touch/feel/play with any pumps do take that opportunity. They really aren't that bulky in reality.

I decided I wanted a tubeless pump. I really love my omnipod and I think it's a fairly sleek bit of kit. I have used a Medtronic 640 too and while I didn't have any particular love for it (I suspect that's more to do with the fact the sensors for the CGM didn't love me) I found I didn't really mind wearing a tubed pump either.

@jimmysmith if you are on mdi and you have a reasonable understanding of the basal/bolus regiem and how to manage insulin on that, then a pump shouldn't really feel like much of a step up. The best prep for pumping would be to make sure you really understand your mdi regiem, then you will have a decent grounding of the basics when you start pumping. So on mdi make sure you've done some basal testing so you know you're basal dosage is correct, make sure you know what you're insulin to carb ratio is for each meal, make sure you know you bolus duration of action, make sure you know your correction factor. These are all things you should (in an ideal world) know on mdi, and they are things that will help in getting the pump set up correctly for you. It does take a bit of effort to get a pump set up correctly for you, but it's not an overwhelming amount of effort. Most diabetes clinics should offer adequate support from a DSN for the first couple weeks of pumping. I would really recommend the book "pumping insulin" by John Walsh. Have a read of the first half of that before you start pumping and you'll have all the key stuff covered. And you'll a book with all the stuff you need to know in one place.

fmacd said:

What puts me right off is having something so bulky permanently attached. I've been Type 1 for 40 years and (at least I think) have always managed my diabetes fine with an HBA1C between 6 and 7 for years. Can anyone tell me honestly if the alien thing always being there isn't a bit hellish or do you get used to it?

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I wasn't sure about this aspect of it either when I was first thinking realistically about whether I could get a pump.

I borrowed a sports belt (a SPI-belt) and carried an old test meter around in it for a day. Then my DSN lent me an old pump, complete with hosepipe and cannula, and I wore that for a week, disconnecting the pump from the cannula (which was just stuck to my skin, not IN me) to shower and to swim, remembering to reconnect each time.

I was AMAZED at how little a deal it was! Yes, I was aware of it, but to waaaaaaaaaay less of an extent than I'd thought.

I knew I could handle that aspect of it - to my own surprise! Now I have a tubed pump, and it's great. I like that I can take it off if I want to (shower, swim, erm sometimes bedroom activities) and I don't have to worry about knocking it during the day or night because it's safely tucked out of the way.

I had thought I wanted an Omnipod. But I'm good friends with my hosepipe pump!

Fab @jimmysmith ! Just be aware that you've got some personal info visible on the letter - might be worth a judicious crop of the pic?

Brilliant news, though!

@jimmysmith youve edited the picture showing, but the attached file with your full name, address & date of birth is still readily accessible. You're probably best off taking it down, unless you like to lay out a welcome mat for the ID thieves?