[Subby]

Some good points made in the posts, and you seem to be on the ball with the main ones qtrchicken. Here's some more thinking on the pump, don't take me to be "this camp or that camp", but as a current pumper with 15 years MDI as well, I do have some perspective to share.

On activity, do you need to eat snacks/energy, to stay level, currently? Do you need to manage activity? Because a temp basal can seriously reduce the need to "manage" around activity. Just wanted to make that clearer, as some points seem to be that a pump is a negative with activity (ie, fragility, getting in the way). Temp basals are a huge bonus in managing activity and sport compared to having long acting in the system, in my experience at least.

As far as being in the way etc, of course in the case of windsurfing etc, I could see why the pump would be at risk. In the case of many sports I think there are many solutions to keep the pump safe enough and out of the way. These things are very tough. Of course there would be a select range of activities where a pump would be a real pain or untenable. You need to judge whether you'd be doing those to a degree you can't "get around" it.

By the way, removing is a cinch and I find that it's no problem to get by for up to an hour, with maybe a small catch up bolus to get basal back on track. So if I was to play basketball for example, I would probably not wear it, and if I was playing more than an hour I would connect, pump an hour's bolus (or something equivalent), disconnect for another hour. These kind of pumping techniques can be developed.

None of this changes whether you personally don't like it attached. I think you can only work that one out by actually trying it. Bit like wearing a watch: some people love it, some are so so, some hate it. Me, I hate any watch, any jewelry etc, I hate wearing anything at all when sleeping, yet I have very little problem with my pump, forget it physically most of the time.

I think what bluesky said was very true... variable basal requirements are a huge benefit of a pump. For those like me, with a variation of about 60% in basal reqs through the day, you might be able to imagine what a nightmare MDI and Lantus was. You don't sound in that boat. Then again you might find some improvements. Has the educator/rep suggested specific ways it will help YOUR situation? (eg, times of hypos, events you come across?)

I don't think that's the only real advantage though, temp basals really have many great applications, and bolusing with a few buttons rather than an injection has to be considered a pretty good bonus... Today, a long day and lots of waiting around airports being bored etc, I bolused 9 times: meals, snacks, a couple corrections. No way I would have injected that many times. Not only painful and unpleasant, also a recipe for site problems (which became a real problem from about year 10 on, in my 15 years MDI). Also, I am assured of the same even absorption rate, being the same site per 3 days. THAT is a huge benefit for me, again probably less so for many others.

Seeing your ambivalence (which I mostly share) about CGMS, I think you should just stick that issue firmly in the background for the moment. Minimed are trying to encourage jumping on board with kit and kaboodle, I do think it's a convergence that will occur more and more, I don't think the current "packaging" is necessarily sinister (although of course it makes business sense), but at the same time I think there is really very little compelling reason to get both at the same time, unless you were to be really keen/sure about it. Pumping is enough to adjust to/assess suitablity of, without worrying about the possibly problematic ins and outs of CGMS at the same time.