I am a type II diabetic, currently taking 21 units of ultralente, the slow acting insulin, twice daily, morning and night, and lispro, the fast acting insulin, on a sliding scale; usually 2 to 5 times daily. I also take 1000 mcg of Metaformin twice daily.

I am considering asking my doc for an insulin pump; because it will probably cut down on the need for all of the combined daily injections, anywhere from 4 to 7 daily, which I give myself. But there are some days, depending on how much exercise, etc. I get, where I only need 2 injections, the morning and night ultralente.

I guess one concern I have about an insulin pump is the possible discomfort of having a needle in me all of the time, and I’m wondering how often is the needle changed, etc. and is it really a discomfort? I know that for some diabetics they have no choice but to use an insulin pump, while for others it may be optional. I receive my diabetic care at a VA hospital, and some of their doctors have said that if you’re using lispro on a sliding scale you should have an insulin pump, but after about 10 years as a diabetic I’ve never had one, and are just now considering it. I have read that insulin pumps are more in use in the UK than they are in the U.S.

So my question is for those who currently have an insulin pump or know something about insulin pumps: Can you please tell me some of the pros and cons of having an insulin pump?

Thanks :)

Hi ZV,
I'm a pump user and, in my opinion, there are no "cons" to using a pump. True, you're attached to it pretty much 24/7 (although you can disconnect for short periods of time, like when showering or swimming), but it's very unobtrusive and I don't find the attachment to be an issue. My A1c dropped 2 whole percentage points within 8 weeks of going on the pump, and has stayed down ever since.

It requires some work, especially at first, to get your basal rates set up correctly, and it doesn't eliminate the need to test frequently...but it does give you so much more flexibility as to when and what you eat. Also, if your blood sugar level does go too high, it's very easy to correct.

There is no needle that stays in you...the insertion set does have a needle to insert, but then the needle is withdrawn, leaving a flexible plastic canula in place. Occasionally the canula gets bent or gets inserted wrong, and it can be uncomfortable, but then you need to change the site anyway as the insulin usually won't be absorbed correctly. In four years of pumping I've had maybe 20 uncomfortable sites.

You change the site every 2 1/2 to 3 1/2 days. Some people can actually go as many as five days without changing, but it isn't recommended. I get 3 1/2 days from each site. Another thing that influences how long your site can remain in place is how much insulin you use on a daily basis and what size reservoir your pump holds. With the amount of insulin you're using, you should probably go for the larger reservoir, as you're borderline for the smaller reservoir.

Oh, gosh...there's just so much info. Can you post back if you've got more specific questions and I'll try to answer them?

Ruth

Thank you Ruth, I know little to nothing about insulin pumps, so you are really educating me. Like I am rather surprised to hear you say that the needle does not stay inserted; that’s new information for me, and also that you say there are no “cons.” I would imagine the 20 uncomfortable sites were sort of a down side, and the initial adjustment period, which I guess is true about most things, nonetheless, it seems you really appreciate your pump over having to give yourself manual injections. By your description there appears to be a benefit to having a pump.

Would you please share with me the circumstances which lead to your getting an insulin pump; was it mandatory for your diabetic condition or optional, and what was the deciding factor? I am guessing that the decision to wear an insulin pump is different for different people? I’ve also heard of “pump packs” but really don’t know what they are? You say that the pump is unobtrusive, so is it visible to others or do you have to wear baggy clothing to disguise it? As I’ve said I really know nothing about it so my ignorance on this subject is glaring. Any input is greatly appreciated.

Thank you,
Larry

Larry,
The pump is about the size of a pager. You can clip it to your belt, or wear it in a pocket. I wear my shirts and tops out, but I know a lot of pump wearers who wear them tucked in and they still manage without too much trouble. There's some tubing attached, and you can get the tubing in a couple of different lengths. I use the shorter length, but some people like the longer length if they tuck in their shirts...that way you can bring the tubing down under and around the shirttail and back up, out the waist, and over to a pocket.

I don't know what people meant when they referred to a "pump pack." I have heard little kids call it a "power pack," but I think they're jokingly comparing themselves to some action figures.

As for the 20 uncomfortable sites being a "down side"...nah...just goes with the territory. If you think of how many shots I would have had to take in four years (5,840) and the total number of sites I've had to insert in 4 years (about 430), 20 bad sites is not even a blip on the radar!

As for why I went on the pump...before the pump I was on NPH and Regular. I had frequent lows, and I had developed hypoglycemic unawareness. The second time I passed out (while driving), my doctor said..."that's it...you need a pump" and I started learning how to count carbs and getting ready to go on the pump. I suppose he could have just put me on Lantus and humalog, but I've also got an eating disorder, and I would have been probably taking 7-10 shots a day. Funny...I finally have the eating disorder under control, but I still wouldn't give up my pump for anything!

I believe the major pump companies all have websites. There's Medtronic (www.minimed.com), and I'm sure Animas and Cosmo (which I believe is Deltronic) must have sites, too. You might get a better idea of what they look like and how they work by checking out the sites.

And, of course...feel free to keep asking me questions. Maybe some of the other pump users will jump on this thread and answer some questions, too.

Ruth

Thanks for the websites Ruth, I will check them out. Some of what you have just said leaves me a little confused; because I thought that most people got on the pump due to frequent high blood sugar levels, hyperglycemia, and you stated in your first post that since you’ve been on the pump your A1c has dropped 2 percentage points, but in your last post you said the reason you started on the pump was frequent low blood sugar levels, or hypoglycemia.

I guess the pump, as you have described, is dosage adjustable and can be used for those who have either frequent high or low blood sugars. My blood sugars tend to be high. I will be 59 in June and right before I turned 50 I had a sudden onset of adult diabetes; my blood sugar shot up to 900; over the past 9 years I’ve only experienced hypoglycemia twice but have experienced hyperglycemia more times than I wish to count. I am at the maximum Metaformin dosage, and some friends have recommended taking cinnamon to lower my blood sugar, but that seems not to help much. So another alternative, besides more exercise, is an insulin pump. My doc told me, when I had my sudden onset, that some people die, go into a coma, when their blood sugar goes over 600.

I am not over-weight, my doc says that I could lose about 15 lbs., but its’ not critical. I have developed a healthy lifestyle; exercise and eating habits. I’ve already shared here on this website that I was blind for 3 years, went through 12 eye surgeries, and now have my eyesight back. My eye doctor draws a direct correlation between abnormal glaucoma pressure readings and A1c readings; so I have more than enough incentive to keep my A1c below 6; the last one was 6.8, and I’m told anything below 7 is good but having already had eye problems my docs also say I should shoot for an A1c around 5.5; keeping my blood sugars between 70 and 120; which unfortunately I usually go well over 120 even with the Metaformin and insulin which I take.

The information which you have shared is very valuable, and yes, I’d like to hear from others as well, as to what made them start using an insulin pump.

Thank you again, Ruth,
Larry :)

Larry,
The whole idea behind pumps is to level out the blood sugars...to prevent both highs and lows. For many diabetics, getting their high numbers down frequently leads to more episodes of lows. With the pump, you can really fine-tune things. For example, you can set your basal rate (the amount of insulin you need to keep your bodily systems functioning even if you don't eat) to tenths of units per hour. And, the insulin is delivered steadily, minute by minute, instead of all at once. Then you program a "bolus" delivery to cover the food you're going to eat.

Another thing, Larry, that most T2's don't realize is that over the years, insulin resistance causes the beta cells to work overtime and can eventually wear them out. This means that your body, despite being a T2, is producing less and less insulin. Eventually, most T2's will need to take insulin. The fact that you're not very overweight (15 pounds isn't much) leads me to believe that your body is not producing very much insulin. In fact, there's another type of diabetes called Type 1.5, which is slow-onset Type 1, where the insulin producing cells die off, but more slowly than in T1.

At any rate, the main purpose of the pump is to even things out. It's extremely flexible. In fact, you can program different basal rates to fit your life patterns. One example is a person who doesn't exercise much during the week but is very physically active on weekends. They could program one basal rate for weekdays and another rate for weekends. For myself, I need more insulin/hour at night when I'm sleeping than I do during the day when I'm awake and moving around. The difference isn't great, just 2/10ths of a unit per hour, but I have the higher rate programmed from 10 PM to 10AM and the lower rate from 10 AM to 10 PM. If I'm on vacation (when I do a lot of sightseeing and much more walking than usual), I can program a temporary basal rate that's lower than normal to compensate for the extra exercise, and I can program it out for 24 hours at a time.

You sure have been through it, haven't you? 12 eye surgeries in 3 years...but thank goodness you've got your sight back. Keeping the glaucoma under control is certainly a good reason for going on a pump!

Ruth

Hi Larry,

I have T1 and have used a pump for almost 2 years. I love it and like Ruth, wouldn't trade it for ANYTHING! Ruth, as usual, has given you a great description of the pump. Something I just did a few minutes ago...my BG went low so I ate something and then suspended the pump for a half hour or so...something you can't do with injections...once you give yourself the insulin, there's no stopping it's action. With the pump, if you go low, you can stop the insulin from going into you for as long as you want.

I don't find it obtrusive at all. The fact that I love it so much helps me deal with any negatives, I guess. I can't really think of any negatives for me. Some people do see negatives with it and have gone off of it so maybe someone like that will come on and talk to you about that. For me, the positives FAR outweigh the negatives. Good luck.

Sharon :)

Ruth, I am extremely grateful for what you are sharing with me; it’s a whole new world of diabetes management which you are introducing me to. From my heart I say thank you! :)

I agree with what you are saying about type 2’s, and how a type 2 who is on insulin eventually builds insulin resistance over time, and generally requires more insulin; which might mean more injections; something the pump is more convenient at adjusting to. I do feel that at some point in my diabetic journey, regardless whatever else I try, an insulin pump is in my future.

I started a thread titled “Sharing My Eye Ordeal” on the Eye and Vision Board, where I talk about my eye problems in detail. I actually had 6 eye surgeries during the 3 year period which I was blind, and have had another 6 eye surgeries since regaining my eyesight.

I am a Vietnam War veteran and it is highly suspected that my diabetes came from exposure to Dioxin/Agent Orange, because I was not overweight and have no family history of diabetes. Prior to age 50 I did not have diabetes, was in good physical shape, ate whatever I wanted without any diabetic symptoms, and never gave much attention to diabetes. My eye problems came before the sudden onset of adult diabetes; which happened right before my 50th birthday. The eye problems are also connected with Dioxin/Agent Orange.

Dioxin/Agent Orange has caused allot of problems in military veterans who were in the Korean and Vietnam Wars. It was heavily sprayed by the U.S. to kill grass and trees so that the people we were fighting could not hide in the bushes. At the time the U.S. Military did not know it would be harmful to it’s own troops, but today there is conclusive evidence that it causes diabetes, a host of various cancers, birth defects, and allot of other diseases.

Again, thank you for sharing your experience and knowledge,
and thank you also Sharon. :wave:

The best thing you can do to manage it. I was taking multible injections for 17 years and got on the the pump right at 2 years ago and my levels have been excellant compared to shots. The crushing lows are gone-- eating schedules are not dictated by insulin peaks they are by you. Its about as normal as you can be if there is such a thing. You do have to test more often but highs are easily adjusted by a push of a button. Most modern pumps have software wizards that do the bolus(Insulin needed to cover meals) by simply entering your blood sugar results and number of carbohydrates you are going to eat. It will then give you the correct amount to take.