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switching to a pump
- Thread starter Niamh1
- Start Date
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If you are based in the UK, I am not sure self funding is possible for a pump. You cannot just buy one like with CGMs. You would need to fund a private endocrinologist as well as the pump and all the set changes and insurance for the pump.
Is a year too early? It comes down to all of us being different. Are you very very comfortable with carb counting? You have to be more accurate with a pump. Are you comfortable with having to revert back to mdi at short notice when under stress? Pumps rarely fail but when they do it is stressful and you have to immediately revert back to mdi, remembering all your doses, Are you happy to carry around pump and mdi paraphernalia most of the time? There can be a lot of stuff to change pump sets and, as I said, you need to be prepared for the pump to fail. Are you insulin requirements stable or are you still in the honeymoon period? Pumps allow you to tweak them but you need a stable start to set up the basal profiles. If you are in the honeymoon period that not be possible. Do you understand how insulin and your body work? A pump is only useful if you understand your diabetes well.
I have found my pump gives me control that mdi never did. However, it takes a lot more effort to do so. As I mentioned, you have to be more accurate with your carb counting. You have to basal test regularly to set basal profiles. The ability to suspend basal when exercising it great if you remember. A basal profile for exercise, ,(or, for women, time of the month) is great but you also have to remember to put it back to standard profile. If a pump fails, you can go high very quickly because you have no background basal at all without the pump.
So, why do you think you would benefit from a pump? Remember, it is just another way to get insulin in you. You still need to carb count, you still need to remember your bolus.
It works for me and I hated reverting to mdi last year. But I was mdilng for over 10 years and I pay very close attention to my levels.
Is a year too early? It comes down to all of us being different. Are you very very comfortable with carb counting? You have to be more accurate with a pump. Are you comfortable with having to revert back to mdi at short notice when under stress? Pumps rarely fail but when they do it is stressful and you have to immediately revert back to mdi, remembering all your doses, Are you happy to carry around pump and mdi paraphernalia most of the time? There can be a lot of stuff to change pump sets and, as I said, you need to be prepared for the pump to fail. Are you insulin requirements stable or are you still in the honeymoon period? Pumps allow you to tweak them but you need a stable start to set up the basal profiles. If you are in the honeymoon period that not be possible. Do you understand how insulin and your body work? A pump is only useful if you understand your diabetes well.
I have found my pump gives me control that mdi never did. However, it takes a lot more effort to do so. As I mentioned, you have to be more accurate with your carb counting. You have to basal test regularly to set basal profiles. The ability to suspend basal when exercising it great if you remember. A basal profile for exercise, ,(or, for women, time of the month) is great but you also have to remember to put it back to standard profile. If a pump fails, you can go high very quickly because you have no background basal at all without the pump.
So, why do you think you would benefit from a pump? Remember, it is just another way to get insulin in you. You still need to carb count, you still need to remember your bolus.
It works for me and I hated reverting to mdi last year. But I was mdilng for over 10 years and I pay very close attention to my levels.
NicoleC1971
BANNED
@In Response is correct to say you can't buy pumps directly in the UK.
I do have a pump but would agree with the sentiments expressed above that its not a magic bullet that replaces the function of your pancreatic beta cells! A year in you are probably spending a lot of mental energy thinking about bg management all the time perhaps? That does get much easier with practice but I don't blame you for seeking a better way because T1 is pretty demanding.
A pump allows for a lot more fine tuning of doses than MDI but this implies more rigorous cab counting with the advantage that pumps always have bolus calculators included. Carb counting whilst better than not doing so, is quite an art but is always presented as just the maths of your carb to insulin ratio when many more factors are involved. So the pump helps but those calculations won't always be correct.
Pumps do have useful features that take advantage of the hourly short acting dosing system i.e. that it is easy to reduce insulin for activity or to increase it quickly when you are ill or stressed for example or extended doses that help you deal with the pizza (fatty and carby meal) problem! But it is still exogenous insulin so if you are eating standard carby diet you will get spikes of longer duration unless you are great at the timing of the dose and live a life when meal timing is totally under your control!
The negatives are around the mechanics of changing the set 3 x weekly , blocked canula, pumps running out of battery charge etc. This hasn't happened to me a lot but the more organised I am about timely site changes the better the thing works!
So are you an organised person who likes to pay attention to detail? Or are you thinking a pump will make blood glucose control better (no evidence for this in studies apparently!) or just make life easier with less highs and lows ? To the latter point I'd say that although my initial blood glucose control hba1c wasn't much lower, I did find my ride on the bg rollercoaster was smoother.
Lastly if you hang on the tech may improve in the direction of closed looping . This has been a game changer for me because my pump is getting readings from my glucose sensor and making minute background changes. I still have to have a low carb diet for good control and I'd recommend that any type 1 thinks about that for the reasons I mention above re carb counting but just because it is healthier!
I do have a pump but would agree with the sentiments expressed above that its not a magic bullet that replaces the function of your pancreatic beta cells! A year in you are probably spending a lot of mental energy thinking about bg management all the time perhaps? That does get much easier with practice but I don't blame you for seeking a better way because T1 is pretty demanding.
A pump allows for a lot more fine tuning of doses than MDI but this implies more rigorous cab counting with the advantage that pumps always have bolus calculators included. Carb counting whilst better than not doing so, is quite an art but is always presented as just the maths of your carb to insulin ratio when many more factors are involved. So the pump helps but those calculations won't always be correct.
Pumps do have useful features that take advantage of the hourly short acting dosing system i.e. that it is easy to reduce insulin for activity or to increase it quickly when you are ill or stressed for example or extended doses that help you deal with the pizza (fatty and carby meal) problem! But it is still exogenous insulin so if you are eating standard carby diet you will get spikes of longer duration unless you are great at the timing of the dose and live a life when meal timing is totally under your control!
The negatives are around the mechanics of changing the set 3 x weekly , blocked canula, pumps running out of battery charge etc. This hasn't happened to me a lot but the more organised I am about timely site changes the better the thing works!
So are you an organised person who likes to pay attention to detail? Or are you thinking a pump will make blood glucose control better (no evidence for this in studies apparently!) or just make life easier with less highs and lows ? To the latter point I'd say that although my initial blood glucose control hba1c wasn't much lower, I did find my ride on the bg rollercoaster was smoother.
Lastly if you hang on the tech may improve in the direction of closed looping . This has been a game changer for me because my pump is getting readings from my glucose sensor and making minute background changes. I still have to have a low carb diet for good control and I'd recommend that any type 1 thinks about that for the reasons I mention above re carb counting but just because it is healthier!
Marie 2
Well-Known Member
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- Type of diabetes
- LADA
- Treatment type
- Pump
I'm going to assume you are a type 1? I suppose if you get a loop pump then a CGM comes with it. But otherwise I recommend getting a cgm first. It makes having a pump a lot easier. I love my pump and would really hate going back to MDI. It makes dosing easier, it's not that I minded shots, I don't, but I just didn't want to bother making small corrections or dosing more than once for a meal. With a pump, it's a press of a button and you can give a correction dose, or extend your bolus over time.You can set a different basal rate for night. Reduce your basal rate when you exercise. They are wonderful things! My control improved with one.
Given that they are not for everyone. It's a trade off. They do take some work, just different work. A lot of people call it tethered to a pump. Because unlike a bolus shot you might just have given with your meal or your one basal shot. A pump is tied to you all day. I know I pay way more attention to my pump than I paid attention when I gave shots. You can have set or pod failures and get no insulin. Most of us carry back up replacement infusion sets or pods and a pen just in case. Because if they fail, which means even knocking it loose, you aren't getting any insulin and that can get bad pretty quickly.
But even with any downsides, I absolutely love my Omnipod pump! It's driving me a little nuts sometimes as I'm having streaks of more pod failures, but I still love it!
Given that they are not for everyone. It's a trade off. They do take some work, just different work. A lot of people call it tethered to a pump. Because unlike a bolus shot you might just have given with your meal or your one basal shot. A pump is tied to you all day. I know I pay way more attention to my pump than I paid attention when I gave shots. You can have set or pod failures and get no insulin. Most of us carry back up replacement infusion sets or pods and a pen just in case. Because if they fail, which means even knocking it loose, you aren't getting any insulin and that can get bad pretty quickly.
But even with any downsides, I absolutely love my Omnipod pump! It's driving me a little nuts sometimes as I'm having streaks of more pod failures, but I still love it!
