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To pump or not to pump that is the question?..

BecciAllgood

BecciAllgood

Member
Messages
9
Location
Telford, UK
Type of diabetes
Type 1
Treatment type
Insulin
hi everyone, I am new to this forum but can't believe I haven't signed up so far!! I'm a 20 year old type 1 diabetic diagnosed when I was 1 1/2 years old. For my younger years I was on 2 injections a day one in the morning and in the evening. I then switched to having injections with every meal and my Lantus before bed around 9pm. My Mom spent so much time ensuring I had my insulin and my hba1c in the children's clinic was never more than 7.5.

When I was 17/18 I was moved into the adult clinic and since then it has gone downhill, I think partially the blame is on me and partially as I moved out of the safety of living with my parents who spent so much time making sure i was always in control. But moving out comes with your own responsibilities and I believe I have gone on the wrong track, I started skipping blood tests and sometimes insulin which I know is awful! I have been in hospital 3 times now with diabetic ketoacidosis and its horrible! But please don't think I am not bothered as I have never missed a diabetic appointment, I have my eyes checked every year and my feet too. I know the complications.

About 8 months ago I visited the clinic for my check up, everything was fine until my hba1c came back as 13.7 of course I was told all the risks and things that this would entail. I decided I'd had enough of being high and constantly drinking and weeing so I made a commitment to get my results down and my doctor said if I showed significant improvement next time he would put a request in for me to have a pump. More determined than ever I went home and stuck religiously to everything, the next time I went back my hba1c had come down to 12.2, and while this is still way too high, I was happy that it has started to come back to normal. The doctor said he was more than happy to transfer me to the pump clinic.

Now here is my issue, in the children's clinic I was offered a pump, but things weren't explained properly to me, I was told about the good points but not given any information and things that can go wrong, so I went away thinking these things were wonderful until I read up on some of the bad things like infections in the injection site area and giving too much insulin, so for a good 5 years I have been anti pump, and I think a little bit of it is to do with me not wanting to give in and proving I can still keep it in control (which I clearly struggle with) myself. However recently I have been thinking more about how brilliant it might be.. I work at Asda as a section leader so my shifts vary from earlies to lates, my meals aren't regular and sometimes I completely forget to check my blood sugar and have insulin, so in that sense having something always there to check for me would be good.

Sorry this is so long so I'll get to the point.. what do you think? Do you think I would benefit from this? Obviously I will have a consultation with a doctor to assess my needs and if I need one, I have lots of questions too but I will save that for another time! I just want someone to give me an insight into what they are like!!

Thanks in advance - Becci
 
Hi BecciAllgood
Welcome to the forum:)

WOW -- what a great first post -- inspirational read and a complete well done to your parents -- mine were exactly like that when i was diagnosed 43 years ago.
moving out gave me my issues but not as bad as you by any stretch !!

My advice would definitely be to go for a pump the advantages ( small constant doses that come a lot closer to mimicking a non diabetic and lots of settings for different types of day - in work , not in work etc , reduced hypos in theory , much more flexibility )

I am about to go on one soon and I had the anti years like you as I thought why fix something that is not broken ( i do multiple daily injections like you) but I have been offered an opportunity now with having restricted hypo awareness so I am embracing it.

I have tagged some other pumpers to come along and a former pumper as he is insightful on pumping
@noblehead , @Mrsass ,@Robinredbreast , @Spiker
 
Hey Becci, My story is similar to yours, Diagnosed 2.5, ok ish until I was a teen then things went badly down hill.

I'm now pumping and have been for 18 months or so. please dont be put of by the stuff about infections, thats fairly rare. Pumps are in the majority easy to use as long as your willing to put a bit of work in to get the correct basals and carb ratios.

I would recommend anyone who is offered one, go for it!
 
Hello Becci,
Pumps are great but can have a downside with some people. I've pumped for almost 8 years now and love it most of the time.
Yes you do need to test regularly yes it's hard work setting it all up.
You just have to remember it's not plug and play, you only get out of it what you put in.
Invest in the book pumping insulin for starters as this will give you a great insight as to what is needed and also helps you achieve it as well.
The pump allows you to set you basal (background insulin) by the hour you can set correction factors and carb ratios plus target blood sugar so the pump works out how much you need or don't need to achieve that target.
 
If you are forgetting to test and forgetting to bolus then the pump will give you no more backup than your basal insulin shots already give you. I strongly recommend that you do not go on a pump unless you have first mastered the basis of testing and injecting. The pump will go badly for you unless you have got those basic skills fully locked in.
 
I think a pump works really well with a less predictable lifestyle - for me, that has been one of the biggest plusses - so on that basis I think it would be helpful for you. I do agree with other posters that you need to invest in getting the basics right to really make the pump work. In particular, I would make sure you're accurately carb counting before starting pumping, and suggest taking some time off work when you start pumping to really focus on basal testing (if you can get that right, it sets you up for success). I'd also make sure you've got the quickest, easiest blood test kit you can get - you *will* need to test regularly with the pump, particularly at the start.

It took me a long time to give the pump a try and I was really uncertain about it, but I don't regret it at all. It has worked really well for me. I think the thing to keep in mind is that going on to a pump doesn't need to be a one way decision - if it works for you, great; if it doesn't, you can always go back to injecting. Bottom line: if you have the opportunity, I'd encourage you to give it a try!
 
There are reminders on the pump for testing BG and bolussing meals. Maybe that would be useful for you.

The pump has its pros and cons but I wouldn't be without mine.
 
Insulin pumps do take time and commitment to get the best from them and is usually only offered to those who are pro-active in their diabetes management, although once programmed the pump delivers your basal (background insulin) you still need to manually bolus for your meals much the same as you do on injections and this involves testing your bg levels so that the bolus wizard in the pump can work out your insulin dose, so if your thinking of moving over to a pump @BecciAllgood you must get into the habit of testing and taking your insulin when you should.

If your wanting to know a little more about insulin pumps and the process involved in getting one then have a read of the following:

http://www.inputdiabetes.org.uk/
 
The best advice I can give you is not to even think about a pump right now. Why? Because it just might get your control better too quickly. I was quite like you at the same age and I decided to get my BG into better shape. Even though it's well known not one single doctor warned me about tightening up BG control too quickly. The result? My sudden improved control triggered retinopathy and I am blind in one eye. So right now start getting those BG readings nearer where you need to be nice and slowly before looking at a pump.

Do a carb counting course as well as you need that before pumping and it benefits you even on mdi.

Secondly I have done the job you do and understand the shifts etc. You should look at getting a libre. It will help you so much without getting in the way of the job. Some clinics are lending them out too.
 
A pump can be great..

However you need commitment to make it work. Going from 13 to 12 was a small improvement and I do not know whether this was after 3 months or 6 months.

My hospital will not give a pump to any patient that has had DKA until they can prove commitment to prove that they have tried everything to bring their hba1cs lower substantially lower.

You will have to prove you can carb count and you know how much to correct by when high with MDI etc before they will give you a pump. You will probably have to do a DAFNE course if you haven't done ine previously.

You need to really start logging every test, every injection etc down now.. Even the foods and the activities you do. As all of this is proof that you are committed and that you stand a chance of taking control of a pump and more importantly.....that you will be able to manage it yourself...

Hospitals don't really want to have pump people that haven't got the commitment to manage themselves.... And it is an ongoing commitment.

You do have to change the sets, tubes, batteries, cartridges etc... Its never a case of pick up test meter and pen and go. The pump is with you for 24 hours a day attached to you. The longest time detached from it would be about an hour to swim ir have a bath.

You have to prove commitment that you can put in the time and commitment to make a pump work...

It can be great but it is only as hood as the effort you put in to it.
 
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