Do I really need/want a pump?

[HelenM]

I've been reading Jeggemans thread on putting his pump away and next week I'm going on a pre pump course. I'm starting to wonder if I really need a pump and what benefits it would give me. I know that I can try it and give it up if I want but I also worry about the morality of using health service resources if its not really necessary.

At the moment I'm on MDI
My Hb A1c is 5%, and has been for the last 9 months. I've only had two readings over 140 in the last 2 months and most post prandial readings are sub 120. My fasting BGs are normally between 70 and 90.
I don't find injections difficult and like the portability of the pens.

I do have lows, predictable ones (exercise induced during and after)They're not disabling ones by any means. I tend to be in the low 50's when I recognise them. The lows are the reason my doctor suggested trying a pump. I carry on the exercise since I know my levels would be very much higher without it.



What do others think? Stick with MDI or try pumping?

[Funnygrl]

Do you need a pump? Probably not. The control you describe is perfect.

Should you try one? Sure, why not?

For me pumping let me take care of a lot of problems in my control- bolusing for high fat meals, dealing with gastroparesis, and frustration toward being low every morning and high every night. It's also great to have temp rates for exercising.

But it's also a huge convenience thing. I don't need to worry about taking Lantus or Levemir at a certain time. I don't need write things down as I do them- the pump memory has it all. and no more shots!

One thing that irritates me is people pumping so they can carry less supplies around. Ah...no. If you're prepared, you'll be carrying around more supplies.

If you have good insurance coverage, why not try it? It's not like you can't go back.

[KritterMom]

Sounds like you have wonderful control. I was never that fortunate, so for me, my pump is an absolute Godsend. I couldn't do without it now. It might be worth a try for you.

[JanTx]

Supplies - yes you need to have as many supplies available, but not on your person. My husband LOVES leaving my "stuff" in the car - and not taking a backpack just for my supplies. My meter case fits on his belt - has a roll of lifesavers in it. Everything else is in the car or in the hotel when we're off on an adventure. My work commute is 4 minutes. So other than a back up meter I leave it all at home.

I've been able to cut my insulin use by about 20% going from MDI to the pump. My control was not near what yours is, though.

I needed the renewed focus on control. Doesn't sound like that's a problem with you.

My biggest MDI problem was being out with friends. Didn't mind shooting up, but .. forgot too often. We'd be sitting down to dinner and THEN I'd remember - and just wouldn't get up to go do it. Now when that happens - a few button pushes and I'm done.

If your insurance pays most of it and it's available - try it.

[notme]

There are several good reasons to use a pump. First for me would be to get better control. It sounds like you still have some pancreas function, but as time goes on that could get worse. Your control right now is enviable.

The other reason would be quality of life. For me it was both reasons. I did not have great control of my blood sugar and I had tried very hard. I also was not good about remembering to carry insulin with me all of the time. I would take a quick trip to the store, run into a friend who wanted to go to lunch, and I would nave no insulin with me. I was constantly leaving the house and then wishing I had put my insulin in a cool bag as I live in California and it gets hot. I hiked a lot and found myself going low all of the time because I was not eating on schedule. With the pump, I was free to be a bit less regimented and for me, that was a HUGE issue.

I think we all have different reasons for wanting the pump. The cost for me is higher, but it is worth it. Way your reasons. If it is just to "try it", then maybe it is would better to wait. If you have some issue or fear or just want a better quality of life then I would say go for it.

[valc3]

I switched to a pump apprx 6 weeks ago, because I kept having lows during and after exercise. I work out every day and this became a major problem. My A1C was 5.4, I am a type 1.5 and I too didn't mind MDI. After a bumpy start on the pump, things are going really well. The pump does offer me a level of freedom that I couldn't achieve on MDI.

[Lloyd]

I'm starting to wonder if I really need a pump and what benefits it would give me. I know that I can try it and give it up if I want but I also worry about the morality of using health service resources if its not really necessary.


I do have lows, predictable ones (exercise induced during and after)They're not disabling ones by any means. I tend to be in the low 50's when I recognise them. The lows are the reason my doctor suggested trying a pump. I carry on the exercise since I know my levels would be very much higher without it.



If you can manage MDI that well, I think you will have no problem with a pump.

You should be able to take care of your lows quite well with a pump. I think your lows should be reason to want a pump, and justification for a need for a pump. It sounds like you are doing a great job with the tool you have, but the lows could be bad especially if one happened while you are asleep.
Go for it!
-Lloyd

[BlueSky]

The only way you will know if it is going to work for you is if you actually try it out. Can you get a pump on loan to try it out and see if you like it?

[Worldcrzr]

I am a Type II diabetic. I was diagnosed in 1982 and in September, 2005 my doctor put me on insulin. I couldn't control my highs and lows with Lantus and Novolog. In February, 2006 I went to a new endocronologist and told him I wanted to go on the pump. I had all the blessings of my Diabetic Educator who made the appointment for me.

I have coronary artery disease of the small vessels. I took an article along that was in one of my diabetes magazines and showed it to him. The article was about "sudden death" in diabetics with small vessel disease who have uncontrolled lows and highs in blood sugar counts. I also had several charts from my history logs showing him how I had done since starting insulin five months earlier. He questioned me about my computer skills and decided I could handle the functions of a pump. He wrote the prescription on my first visit. I still have some lows and some highs but not daily like I had before the pump. My last A1c was 6.5, down from 8.5 on shots and I'm hoping for an even better count my next test.

You have to evaluate your need for the pump. If you are satisfied with your test results and taking shots, you probably do not need the pump. There are some of us where the pump is our lifeline. I probably would never have gone on the pump if I could have controlled my highs and lows but I couldn't. Now, they are well under control with little effort from me.

[cheryl]

HI Helen,

It's your call your doing lovely on mdi's and I for one am choosing a pump for the less of lows when I am active which happens a lot, I can tell ya how I do when I am actually hooked up, I think I could do better on mdi's but once my mind was set on the pump, I kind of just have dealt with it......


Also my sugars are a little more rocky then yours are but not too bad, but I do get high sometimes which ticks me off and there is no reason for it at all, just cause i sit for 3 hrs then boom I am going up that is why i want a pump so if I decided to be a bit lazy in the afternoon or what not I can make my rate a little higher, my decision on a pump was flexability in my activity, nothing more.....

cheryl

[Cyborg]

Personally, I would never go back to MDI. MDI cannot do what the pump can do for me and there is no way I could ever achieve the control I now have.

[HelenM]

Thankyou everyone for your replies. Most of you seem to feel that there would be some benefit but probably not necessary. Val seems to have gone on the pump for similar reasons to me and its working out well.
I can try the pump for 6 weeks so the decisions not unchangeable.

I will go on the course next week and try to talk to my doctor about some of my misgivings but its very difficult expressing what I mean in French. (its also going to be very difficult following a course in French but I've bought John Walsh's book which will hopefully get me through it)

I agree with Notme, I've felt for some time that I'm probably lucky and have some pancreatic function left and that has so far made control easier . ( I've read that the older you get LADA the longer the residual insulin production lasts) As she says it might not last forever. Also some of my hypos (which I 've become rather blase about) have been very low I'm sure whats my doctor is worried about.

Financialy I'm not dependent on insurance as all my diabetic care is 'free'. Thats what puts me in a slight moral dilema as I don't want to misuse the French health service. (its ironic I've paid thousands into the British Health sevice and used it very little and not much into the French one and used it a lot)

Incidently almost all my education on MDI has come from this site. I came out of hospital with a fixed carb and insulin amount for each meal, so its thanks to everyone here that I've learnt how to use MDI effectively. If I decide to try the pump I know I'll be able to get good advice.
Thanks, Helen

[Gordonm]

I was against going on the pump for years. I have been a type 1 for 32 years now and had many thousands of shots. The ynever bothered me at all. I finally decided to give it a try. Well it has been great. My control before the pump was A1cs in the 5.6 to 6.2 range so I was in pretty good control. My first A1c on the pump was a 6.2. Not bad considering the first month you are all over the place trying to get the pumpsettings correct. I now have way fewer lows and the yare not as severe as the yused to be and I rarley have a reading above 200 now. Most are in the 80 to 120 range. According to my pump and BG meter my average has been right at 100. What I like best is tha tI no longer have to leave the house with needles insulin and a bag full of supplies. My job has me travel by car most of the day. I no longer have to give a shot at each meal. I just reach down hit a few buttons and keep going. It is far less work and far less to carry with me. I do not want to go back to shots at all. Some do not like having to be attached all the time. Tha tis not even an issue with me. I am very active, gym, bike 30 to 40 miles and spend the summer at the beach. The pump has just made life easier for me. I would say give it a good honest try for 3 to 6 months and see how you feel about it. Good luck.

[am1977]

Helen~ you have to do what you feel is best for you.

Personally, I agree that you will never know if the pump is for you unless you try it... I don't know if it will definitely improve your control-seems like you have excellent control as is- but I feel like it gives me more control over how I manage by Diabetes... What I mean is, I feel it's easier to control my insulin useage, rates, and what have you. On MDI, I didn't feel like I had that power... Plus, it was nice being able to just push a button to deliver my insulin instead of running to the bathroom to take a shot. And, for me, I hated shots.

I certainly don't think it will hurt you to try it. And if you decide it's not for you, you still will have MDI to go back to.

Good luck :)

[jeggeman31]

I've been reading Jeggemans thread on putting his pump away and next week I'm going on a pre pump course. I'm starting to wonder if I really need a pump and what benefits it would give me. ?

Wow people do read what I write:D

For me I just got tired of it. Prior to the pump I was of course on MDI, however due to my treatment and my non ENDO DR I was not educated in the word of diabetes, and out of control. When I found out about this site, I found out about ENDO'S and pumps. When I changed from my Dr to an Endo my control went down to close to what yours was just before the pump. However I decided to go with the pump. I kept my A1C below 6 for some time on the pump. However this last 6 to 8 months my A1C keeps creeping up and I am over 7 now. For me that is something I don't want. So I figured I would put my pump away and and see if I can get back down to 5ish with MDI again. If that does happen, I don't know if I will go back on the pump at all or stay with MDI.

Yes the pump makes you feel more free or normal as some people say, because you don't have to take shots. However I don't look at it that way, shots are just something that needs to be done. Only takes 2 minutes.

I say go for it. Yes your control is wonderful on MDI, but if you can keep the same control and feel as more normal then why not continue to use it.

My motto is I control diabetes, it does not control me. So when my A1C goes above 6 I feel it is starting to take over and I need to do something to correct it. That is just me.


Good luck with the pump, and make sure you keep us updated on it.

[HelenM]

Wow people do read what I write
Yes and much of its filed away somewhere in memory for future reference!
I read far more than I post. I'm sure I'm not the only one. I suspect that there are lots of people out there who don't have the confidence to post at all but have still gained lots from this forum.

Thanks again everyone,

As I said I'm at least going on the course. That starts tomorrow. It should be interesting and will have the side effect of helping my French and meeting some younger people (I fully expect to be the old lady of the group).
I have to take with me the results of blood tests including a full blood count as well as the normal diabetic ones, a recent retina check, log book, food diary with weights of foods and walking shoes.
This is only stage 1, If I decide to have a pump thats up to another week as an inpatient 150km away in Toulouse, the French health system is thorough!

[Cyborg]

Don't let your fears prevent you from at least trying the pump. I think the majority of pumpers on this forum (the best diabetes forum, IMO) would only give up thier pumps if it they absolutely had to...

[ant hill]

At the moment I'm on MDI
My Hb A1c is 5%, and has been for the last 9 months. I've only had two readings over 140 in the last 2 months and most post prandial readings are sub 120. My fasting BGs are normally between 70 and 90.
I don't find injections difficult and like the portability of the pens.
You seem to keep well Helen :)

What do others think? Stick with MDI or try pumping?

Stick to the MDI i think the pumps are not cheap and also the consumables too. :thrasher: :flowers: