Thinking of getting a pump

In Response said:

I need pump changes in case the cannula fails.
For a few hours, I carry a syringe and a vial of insulin but, if I got overnight, I also carry my insulin pens in case the pump fails.
And, when going away overnight, I will take twice as much of everything including pump sets.

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Steveee said:

Hi, I’m on my 5th insulin pump so my pov is positive. Over the 15+ years I’ve used it they technology has changed and improved a lot and is about to take a big step forward with the 1st commercial hybrid loop pumps starting to become available on the NHS.
Like you I was struggling with control before I started on the pump.
Is it painful: similar to injecting so no. Is it easy to apply: most modern pumps have an applicator for the cannula. Is it difficult to get: really depends on your local ICS and the criteria they use. Yes, they should follow NICE guidelines, but as these are guidelines, many apply them and some add additional restrictions. If you struggle with control, or have lots of hypos because you’re trying to get your HbA1c down, this is often a reason.
PROS: you can profile your basal rate far closer to your real background need. This will reduce number of hypos under normal circumstances.
You can bolus precisely to the carbs you’re eating, even doing a fraction of a unit.
You can do an extended bolus (deliver bolus over multiple hours) to match the glycaemic index of the food. For instance, for a pasta meal I bolus 60% immediately and 50% over 4:40 hours!
You can adjust basal rate for different types of exercise. You need different basal depending on aerobic vs anaerobic exercise.
You only need to change cannula every 2-3 days, e.g. you don’t have to excuse yourself to do a jab when eating out.
Basically it allows you to be more flexible.
CONS: because basal insulin is fast acting, if it stopped, you quickly go hyperglycemic.
The modern pumps and associated apps do a lot of the maths for you, but you have to think all the time about how many carbs you’re eating and the type of carbs.
When travelling, you have to carry a lot more equipment, eg spare insulin reservoirs (each typically only 160U), spare cannulas and tubing, backup insulin pens incase pump fails, spare batteries or charging cable.
Most pump teams will require you to do a DAFNE course before starting. Needed to get your insulin sensitivity and basal requirements calculated. Means you will have to take time off work for this training.

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In Response said:

I have had two different pumps.
Both have a capacity of 200U. I understand there are some that take 300U but as I use less than 120U in three days, I have never looked much at these. Likewise, I have avoided pre-filled cartridges.


My DAFNE equivalent course was after work, one evening a week for 6 weeks. It is not always necessary to take time off work.

I guess what we are showing is, if you think you will benefit from a pump (not just that you want one) you need to discuss pump options and criteria with your clinic because there are many variations.

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In Response said:

Depends on the type of pump you have.
You can keep your pump attached, especially if it is a patch pump.
Or you could detach a tubed pump.

It depends how long you are in the pool and what impact it has on your levels.

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