# 8-10 injections a day - should I pump?



## Rob64 (Sep 15, 2020)

Hello all, I am new to this forum.

 I found it as I'm looking for a few answers if anyone could be kind enough to reply.

As in the thread title I now find myself having to take up to 10 injections a day to try and keep my levels within the limits deemed healthy from my NHS diabetic team and consultant.

I am being consumed with this level of monitoring/injecting (it just seems to be taking over my life at the moment)

I've been type 1 since 1981 so I am far from new to this awful ailment but have been really struggling recently keeping my levels in check.

I'm asking whether a pump would be the way to go as all these injections are a real pain 

Thank you for any future replies 

Rob


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## helli (Sep 15, 2020)

Typically, the value you get from a pump is not about reducing the number of injections. I probably bolus a similar number on my pump. 
The point to consider is why you are having to inject so often. 
Is it because you are needing to do lots of corrections? If so, have you done a basal test and checked your insulin to carb ratios to ensure these are correct ... and valid for different times of the day. 
Is it because you are snacking a lot? You will still need to bolus for every time you eat. That will not go away.
Is it because your basal needs vary throughout the day? A pump would help for this because you can change you basal every 30 minutes.
Is it because you are eating meals than require dual boluses such as pizza and curry? The pump could help this because you can set up a bolus that is dosed over multiple hours. 
Have you spoken to your diabetes team about the criteria for a pump? This seems to vary per CCG so it is very important to find out whether you are likely to qualify before getting your hopes up. 

I have been pumping for about 6 years. My criteria was related to hypos when exercising and the pump has enabled me to lower my basal. 

However, if you think injecting is a pain, changing pump sets would blow your mind. You may only need to do it every 3 days but it is very tedious. 
With the pump you have to be more accurate with your carb counting so if you are injecting extra times because you miscalculated the carbs, the pump would not help. 
And then there is the risk your pump may fail so you could have to return to injections. 

The pump has definitely helped me but that help does not come at zero cost. I think I work harder to manage my diabetes now I have a pump than I used to with injections.


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## Thebearcametoo (Sep 15, 2020)

As Helli says it depends a lot on why you need that many injections. It sounds like either your basal is not suiting you, your carb/insulin ratios aren’t right or you’re not matching your carb intake to your insulin (that can be a timing of the injection or not accurately counting carbs or not accounting for exercise or a whole host of other things). Have you spoken to your team about what’s happening?
Sometimes when people have a chronic condition for a long time knowledge and management changes over time and this isn’t always communicated well to patients. If may be worth asking for a review of your needs and maybe looking at getting the same info that a new patient would get now to see if there are other things you can change to help you out. That many injections is such a lot of your time to be thinking and dealing with your diabetes and you must be fed up with it.


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## JohnWhi (Sep 15, 2020)

I agree with what the others have said, but would also observe that moving to a pump drastically reduced my insulin requirements. I am also type 1 since 1981 and started with the pump just under three years ago. My problem was not high blood sugar levels but unpredictable levels. The pump has made things much more manageable.


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## Pumper_Sue (Sep 15, 2020)

I think you need to learn how to use your insulin correctly first.
No1 do a basal test (details top of the page)
No 2 then check your carb ratio and that you are counting carbs correctly.
No 3 check your correction factor.
No 4 look into what duration of insulin you are using.

It sounds to me as if the amount you are injecting would be the main cause of your problems I would suspect you must be imitating a yoyo with your blood sugars.

Can you tell us what exactly is going on in your daily management so we can perhaps give you some pointers to help you out?

A pump wont actually help you unless you have a clear understanding of how your insulin's work and it's interaction with food/exercise.


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## everydayupsanddowns (Sep 17, 2020)

In short I would say, “Yes”.

Because you are always connected to an insulin supply with a pump taking an extra bolus is only a few presses of buttons, so you can be more conservative with any corrections you think you may need (or use other gentler options like increasing / reducing basal)

Additionally even if your carb counting is no exactly 100% precise some of the time, all your doses ARE more precise, down to tenths to even hundredths of a unit.

Plus you will be able to precisely tailor your basal dose, which means you will have fewer ‘Hobson’s Choice’ periods of the day where your basal jab(s) either fall short or overshoot.

But as smart as they are, pumps are still pretty dumb bits of equipment (even the snazziest hybrid closed loop ones) and rely of you keeping your doses, ratios and basal profile properly tweaked week by week and month by month... and require you to accurately estimate carb intake as precisely as you can, along with the other finessing around dose timing and splits / extensions (dual wave and extended boluses for slowly absorbed carbs).

A pump won’t magically fix any fundamental management gaps, but it will add accuracy, flexibility, semi-automation, and extra dose/insulin options that injections simply cannot.

It sounds like you are working really hard on your T1 management and would potentially have a lot to gain.


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## jlury (Nov 7, 2020)

Hi. The simple answer is yes!
I was also diagnosed T1d in 1981. I have been pumping for 14 years and using dexcom CGM for 5 years.
I mostly agree with what others have said above. but based on your introduction you are already putting in a lot of effort, and based on my own experience from starting in a similar situation a pump will make your life easier because the insulin you inject will be absorbed more effectively and you will be able to control your basal rate more effectively. The downside is that you have to put some work in to use the pump to best effect, but a pump will definitely be an improvement for you.
Also, for the future you will be positioned ready to try the revolution with "Looping" which is gathering momentum (Looping = the pump reacting to CGM readings and taking some control of insulin dosing. I havent tried looping yet but the data is v good and it is the logical next step). ..... and the artificial pancreas is not far away (insulin pump + Glucagon pump + CGM working together).

Good luck!
Jon


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## SB2015 (Nov 7, 2020)

Like others I have found that a pump has enabled me to tune my basal insulin to match what I need hour by hour.  This takes a bit of work but for me it was well worth it as it reduced the lows Inwas having during the night and also improved things during the day.

I particularly like the different ways if delivering my Bolus insulin  on a pump with the multiwave, extended and standard Bolus.  I have learnt over the years what I need for different foods.  Pizza is still a no no for me as it is just too much hassle, but homemade curries work with the different deliveries.

Exercise is so much easier with a pump.  I don’t need to pan so far ahead as I can temporarily turn the basal insulin down so long as I know what I am doing about an hour ahead of time.  Before I needed to know first thing in the morning on MDI.

I would never waNT to go back to MDI, but I do know that it takes some effort to set it up and to review settings at regular intervals.


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