# Pump doubts



## mum2westiesGill (Oct 4, 2016)

As some of you may have seen I'm considering an insulin pump. I've got an appointment with my GP on Thursday to ask if I can be referred to the Dr at the pump clinic at the hospital - my diabetic care is done at my GP surgery.

I'm having a second thoughts day today because
1. If you still need to keep back up supplies for injections in case of pump failure then why bother going on a pump? 
2. If your pump does ever fail & you have to go back to injections for a short while then why not stay doing injections?


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## Pumper_Sue (Oct 4, 2016)

It's only a matter of a day if it does fail and it's very rare they do. With anything medical you should always have a back up. If you use your logic it makes a mockery of blood testing doesn't it? You have two meters in case one fails or is lost so does that mean why bother to test?


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## Sally71 (Oct 4, 2016)

Hopefully your pump won't ever fail, but just in case it does you don't want to be stuck without insulin!

Pumps are better for a lot of reasons, they are much more fine tunable than injections so you should be able to have more stable blood sugars.  If you are ill or exercising you can temporarily increase or decrease your basal for just a few hours.  Or if you are having regular highs or lows st the same time every day then you can adjust your basal just for the few hours when the problem is and leave the rest of the day alone, you can't do that with long acting insulin!  You can also do things like extending meal boluses if you are eating something which digests very slowly, so that the insulin delivery more closely matches the food digestion.  It can be hard work trying to get everything adjusted right, but then so is MDI if you are doing it properly.  We have been pumping for 4 years now and would never want to go back to injections, even though they work I'd find them very crude by comparison!


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## mum2westiesGill (Oct 4, 2016)

Pumper_Sue said:


> It's only a matter of a day if it does fail and it's very rare they do. With anything medical you should always have a back up. If you use your logic it makes a mockery of blood testing doesn't it? You have two meters in case one fails or is lost so does that mean why bother to test?



Thank you


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## mum2westiesGill (Oct 4, 2016)

Sally71 said:


> Hopefully your pump won't ever fail, but just in case it does you don't want to be stuck without insulin!
> 
> Pumps are better for a lot of reasons, they are much more fine tunable than injections so you should be able to have more stable blood sugars.  If you are ill or exercising you can temporarily increase or decrease your basal for just a few hours.  Or if you are having regular highs or lows st the same time every day then you can adjust your basal just for the few hours when the problem is and leave the rest of the day alone, you can't do that with long acting insulin!  You can also do things like extending meal boluses if you are eating something which digests very slowly, so that the insulin delivery more closely matches the food digestion.  It can be hard work trying to get everything adjusted right, but then so is MDI if you are doing it properly.  We have been pumping for 4 years now and would never want to go back to injections, even though they work I'd find them very crude by comparison!



Thank you


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## mum2westiesGill (Oct 4, 2016)

So I guess I should keep my GP appointment for Thursday to get this ball or should I say pump rolling


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## Sally71 (Oct 4, 2016)

Definitely worth a try I'd say, they don't work for everyone but you don't know until you try!  I was very skeptical but allowed myself to be talked into it and I'm so glad I did, we've never looked back.  Even if you try one and decide after a few months that it isn't for you, you can always go back to pens!


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## Pumper_Sue (Oct 4, 2016)

mum2westiesGill said:


> So I guess I should keep my GP appointment for Thursday to get this ball or should I say pump rolling


As long as you realise how much work is involved with pumping, there's a lot of testing you have to be able to change the pump settings yourself and also have to refrain from eating during basal testing, I know you love to snack so can you manage all that?


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## heasandford (Oct 4, 2016)

You can give small amounts of insulin accurately - I always used to worry than less than 2 units probably wasn't anywhere near, how much do you lose in a pen when delivering that amount? - but the pump is continually delivering the tiniest amounts as background anyway. 
Much more stable background insulin, my pump has a different setting for every hour, much less overnight until time to wake up then it doses more as necessary - Lantus/Levemir couldn't do that.
I have a pump which is remote controlled from the meter, never touch it during the day - this proved to be the added advantage that I really really love! I have just come back from St Petersburg, serious amounts of back-up equipment etc, but just so easy to deal with a pump.
Go for it!!


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## Radders (Oct 4, 2016)

I think you do need to be convinced that it will be worth it. Keep asking questions until you are satisfied that it will work for you because as Sue says, there is a lot of work involved. 
Saying that, I would fund the pump myself if I had to: MDI just didn't seem to work for me. My absorption of long acting insulin was so unpredictable that to get reasonable numbers I risked serious hypos on a regular basis. With a pump I only have fast acting insulin which behaves much better for me.


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## spiritfree (Oct 7, 2016)

I use a pump, Insight from Accu chek. It has a remote control so you don't need to get your insulin pump out in public. The remote looks like a mobile phone. I would recommend pump therapy for any type 1 who is able to get one. Like someone else said if you don't get on with it you can always go back to pens. What have you got to loose?


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## mum2westiesGill (Oct 23, 2016)

Pumper_Sue said:


> As long as you realise how much work is involved with pumping, there's a lot of testing you have to be able to change the pump settings yourself and also have to refrain from eating during basal testing, I know you love to snack so can you manage all that?



So I'm still having my doubts. At my last diabetic appointment on 14th October with my practice nurse & also with the DSN the DSN agreed that there is a lot more work involved, yes there is a lot more testing, learning how to change pump settings, there will also be basal testing involved however she said to still think about it because one thing where it might be useful is that one very big thing of mine is when I'm eating out but also even at home sometimes I do my test then I don't know what comes over me but I can't be bothered to then get my injection pen out put the neeedle on & inject. The pump as far as I know would be still to work out carbs but then it would be a case of pressing a button to inject. I do have an appointment mid November with the Dr at the pump clinic at the hospital so do I go or don't I go?


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## SB2015 (Oct 23, 2016)

Using the pump in place of injections is far better in my opinion.  It is so much more flexible, as I can:
- match the delivery of background over the 24 hours to match my needs 
- turn down the basal rate at any point during the day in response to a change of plans
-have a lie in as I do not need to wake up at the same time every day to do my morning background injection
- set temporary reductions in my background to account for different levels of activity
- deliver my bolus insulin in a way that matches the food that I have eaten such as 
   Extended delivery over 2 hours (for pasta)
   Multi wave delivery (some up from for fast acting carbs and slower for the rest)

And so much more.  I would never go back to MDI but happily carry around my pens when more than one hour from home as I know that if the pump fails (which it never has) it is necessary to replace the insulin quickly.

It takes time to set it up to match your needs and you need to monitor the rates that you use but it is worth it.


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## trophywench (Oct 24, 2016)

Gill - the initial learning curve is mega and none of us would kid you that it's not, I'm sure.  I found it frustrating at times to begin with since after jabs for so many years, without realising - you do what you need to almost instinctively - you don't have to think.   With this alien gadget in my life - I had to THINK more - just had to grit my teeth and do it by myself - because it really is down to YOU.  (Although the back up will be there when you do get stuck)  However usually you do get used to it very soon and pumping becomes instinctive too.

We all have so much better control of our BGs on our pumps Gill - and the older we get, the longer we've been diabetic, and the more likely it is that complications (and other health issues) could rear their ugly little heads - the more important achieving really good control becomes.  That's one of the reasons we are all so determined to master our pumps and live happily with them to a ripe very old age!

It really is down to you whether you believe you will actually apply yourself to learning how - and be honest with yourself when you ask yourself that question.  If you believe in yourself - you can do it.


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## Alba37 (Oct 24, 2016)

Sally71 said:


> Definitely worth a try I'd say, they don't work for everyone but you don't know until you try!  I was very skeptical but allowed myself to be talked into it and I'm so glad I did, we've never looked back.  Even if you try one and decide after a few months that it isn't for you, you can always go back to pens!



I totally agree, and Medtronic have a great replacement policy.  My son has been pumping 7 years and not had 1 injection.  Good luck x


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## Pumper_Sue (Oct 24, 2016)

mum2westiesGill said:


> So I'm still having my doubts. At my last diabetic appointment on 14th October with my practice nurse & also with the DSN the DSN agreed that there is a lot more work involved, yes there is a lot more testing, learning how to change pump settings, there will also be basal testing involved however she said to still think about it because one thing where it might be useful is that one very big thing of mine is when I'm eating out but also even at home sometimes I do my test then I don't know what comes over me but I can't be bothered to then get my injection pen out put the neeedle on & inject. The pump as far as I know would be still to work out carbs but then it would be a case of pressing a button to inject. I do have an appointment mid November with the Dr at the pump clinic at the hospital so do I go or don't I go?


Yes there is a lot of work involved and it's not just for the first 0 - 6 months of the first set up as basals need tweaking on a regular bases and you have to be 100% clear in your mind regarding bolusing you must bolus for what ever you eat otherwise you will end up DKA, there's no I'll just have a 10 carb snack and wont test and bolus for it.
Bottom line is if you know you wont do this then a pump isn't for you, you need to be 100% sure you want a pump and can change habits of a lifetime.
It's your choice and your life, you will need to test a lot more and act on those test results and never bolus or eat with a test first.


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## Alba37 (Oct 24, 2016)

Pumper_Sue said:


> Yes there is a lot of work involved and it's not just for the first 0 - 6 months of the first set up as basals need tweaking on a regular bases and you have to be 100% clear in your mind regarding bolusing you must bolus for what ever you eat otherwise you will end up DKA, there's no I'll just have a 10 carb snack and wont test and bolus for it.
> Bottom line is if you know you wont do this then a pump isn't for you, you need to be 100% sure you want a pump and can change habits of a lifetime.
> It's your choice and your life, you will need to test a lot more and act on those test results and never bolus or eat with a test first.



My son has slight dyslexia, and he has found a pump so much easier than injections.  From trying everything to get good control on injections, he gets results for his efforts now. Not everyone finds it hard work.


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## Pumper_Sue (Oct 24, 2016)

Alba37 said:


> My son has slight dyslexia, and he has found a pump so much easier than injections.  From trying everything to get good control on injections, he gets results for his efforts now. Not everyone finds it hard work.


Yes I know not everyone finds it hard work but if you read Gill's post I think you will find she struggles a lot with compliance and just doing the basics is a struggle for her.
As already stated Gill has to make the choice/commitment herself.


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## mum2westiesGill (Nov 14, 2016)

My appointment with the Dr at the pump clinic at the hospital is on Wednesday. I think I have made my decision after lots of questions & that is to stay on MDI because:
I've been injecting for 23+ years so it's a part of my life now & I really don't mind the injecting except when I'm eating out & then for some reason sometimes but not every time something comes over me to think "s*d it I can't be bothered doing an injection and just get on with my night out"  
I don't have to have anything attached to me 24/7. I most likely would wear the pump on a belt around my middle and I don't think that's for me.
I don't have anything to un attach & re attatch when I have a shower
I'm in no danger of rolling over onto anything in my sleep - probably wouldn't happen anyway but...

I'm happy to carry on with MDI as long as I get good support with my D team & my new team (practice nurse at my GP surgery) seem to be very helpful
I'm trying very hard at the moment to inject for everything I eat which is over 10g carbs


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## grovesy (Nov 14, 2016)

Good luck with your appointment!


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## mum2westiesGill (Nov 14, 2016)

grovesy said:


> Good luck with your appointment!



Thank you grovesy but I'm not going I'm canceling x


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## Sally71 (Nov 14, 2016)

I think you have made the right decision for you! Pumps are great but they can be a lot of hard work, and when you change over you have to relearn everything from scratch almost. Plenty of people are happy on MDI and can control themselves well on it.  Well done for making the effort to inject for everything!
(And I think we all have days when we don't want to be bothered with any of it any more, unfortunately that isn't an option )


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## Radders (Nov 14, 2016)

Well done for coming to a decision which is right for you. If you are managing good control on MDI then well done as well! I never managed this without regular and sometimes drastic hypos.


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## trophywench (Nov 14, 2016)

Gill - however we control our T1 (MDI or pumping) the only ones that are likely to suffer if we don't bother  are not only ourselves - but also our nearest and dearest should we decide 'S*d it - I can't be arsed'.  Not only do I not want to feel vile and have complications should I not bother keeping on the straight and narrow - but I also don't think I could live with having caused members of my family angst and needing to manage it for me, when I could have avoided shoving all of it onto them just cos I couldn't be arsed.

So - it's entirely in your own hands Gill - whether you live a long and happy life with your D or not - no matter how you actually treat it medically.

Just make sure you stick to your New November Resolution though - we're all watching you!  LOL


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## novorapidboi26 (Nov 15, 2016)

Hi Gill,

Its not really about the convenience of not injecting anymore that encourage people to go on the pump, its more about how it delivers the insulin....

Everyone would benefit from the pump, but not everyone needs it or is ready to go on to one....

all clinics are different too..........my clinic wouldn't approve a patient who hadn't been already dose adjusting/basal testing for a good while with no success......

So if you get the opportunity to go again, you should, at least just to get a feel for what they might be like and what they want form you....


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