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Insulin Pump vs. Injecting for Active People

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#1
RyanN

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A question regarding insulin pumping:

I am a very very active person. I live in a big city, so I always walk everywhere--on average 6kms per day; plus, I exercise a lot with bicycling, weights, and my martial arts training.
Currently, I inject Lantus/Humalog. My body is really
sensitive to my insulin, plus I must adjust my dosages
according to my prospective physical activity.
My problem is that I get a lot of ups and downs with few
steady rides, resulting in a frustrating A1C.

For those of you on the pump, would you recommend it for
someone with an active lifestyle, or would it be best for those with more sedentary lifestyles?

Are there any really active folks out there using the insulin pump?

Any info would really help.
Thanks again,
Ryan

________________
Type 1 since 1991
Lantus/Humalog
Last A1C: 9.1:mad:
Recent Feelings: Hopeful

#2
RLK

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My insulin pump is, hands down, the best way for me to manage my diabetes without sacrificing my active lifestyle.

I work 2 jobs, both of which are at least somewhat active, cycle a lot (including commuting to work during the spring-fall months), ski, and hike, among other things.

Pumping takes a lot of work, and a lot of BG testing, especially when you're first getting your dosages figured out. It's not cheap either, at least here in the U.S. But, if you're committed to it, it can work very well. Like all treatment methods, some folks love it and some don't. I count myself squarely amongst those who love it and have found it life-changing.
Becky
T1 since 1998
Pumping since 1999

#3
1type2go

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I've been weight lifting for about seven years and it was the best thing for me ,...I then got into managing my BG and testing on a regular basis .Consistency is key right down to What you eat When you eat (close to the same thing at the same times each day) and not going by feel !!TEST and look at glycemic index of the common foods you like ,high GI before work out and take a juice besides your water with you.It sounds like you've got the idea of adjusting for activity but if you keep a log of what you eat EVERYTHING you eat then put it into context with GI and carb grams or if you must calories,you will then know IF you test constantly where you can tighten up .

If you feel you're sensitive to insulin and you have an A1C at 9 you've been running way to high with out testing at the right times .


Just my two bits

and I do think pumps are the way to go!!!!$$$$$

Donovan

#4
stlduckhunter

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I am very active. Travel a great deal, spend two weeks in France every month. I work on a treadmill 40-50 minutes daily and play golf and hunt and fish in season. I love the pump as it has smoothed out the highs and lows. It is not pain-free but nothing is. It takes some time to get used to it and the doseages for exercise but it is wonderful.

#5
morrisma

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Pump is the way to go. I have used it on backpack trips, summer camps, all manner of gym visits, long cycle trips, etc. It allows you to adjust basal rates based on anticipated activity. You will need to test a LOT to get the thing tuned for your individual body but once set, you should have the ultimate (aside from a real pancreas) in flexibility.
Good luck,
Mike

[SIGPIC][/SIGPIC]
Type 1 since 1988
Pumping since 2002
CGMS since 2010


#6
Subby

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Hi RyanN,

I've been on the pump for a few months now and although I still have difficulties I can say it is a vast improvement to injections, as far as flexibility. People have mentioned it but I wanted to explain a little more in detail about variable basal and how it is miles ahead of a flat basal like lantus.

As well as all the wonderful bolusing options I won't get into here, the pump uses your short acting insulin for your basal. You programme in what basal rate you want and it drip-feeds the short acting into your body.

This has a number of fantastic attributes as far as control and things like exercise:

You can program your basal rate to varying levels, by the half hour, though the day. Typically pumpers seem to find that 4 or more differing basal rates afford much better basal coverage for their "average" day. To cater for things such as, higher "stress" at work, dawn phenomena, exercise, sleep, and the wonderful hidden metabolic variances through the day (these can be very significant). I have about 9 different rates and the lowest is half the highest. These are still works in progress but far better basal coverage than a flat like Lantus.

Furthermore you can program different patterns, or days/half days whatever, to suit different situations. Work out on Thursday? Have a completely different basal pattern that you switch to on that day.

OR, you can quickly program a "temporary basal". So if I am suddenly going for a long walk/jog, I can say "set to 80% of my normal rates, for the next 3 hours". Or, if I have a stressful shift at work coming up and I know my BG will spike, I can say "Set to 125% of my normal basal for the next 6 hours". There of course is still a lead time, of the quick acting already in your system, so it is best to start a temp basal say 2 hours before, but even if not you can get around this, you can take some more energy until your lower basal kicks in.

If you really like to push yourself, you could have a period of the day where you have a very low basal, and then later on it returns to "normal" levels. There are many more functions and benefits. Of course mileage varies with effort and testing, but the possibilities are enormous compared to dealing with a 24 hour dose of Lantus.

I hope that starts to show in understandable terms that a pump provides huge potential to deal with varying activity, a completely different level of manipulation of your insulin levels from hour to hour.
20 years T1. NPH and Novorapid.
Some essentials for my blood sugar control: dosing via i:c ratio and cf • basal testing when needed • daily 40 minutes moderate exercise (or close) • carbs somewhere below 120g currently • only eating carbs and carb/fat combos that do not cause a problem spike, with or without insulin.

#7
xMenace

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It's definately the best choice. My natural rythms are whacky enough without any activity. Pumping has been a life-saver. I also like to sleep in on weekends. I can sleep all day long and know I'll be stable.

But one caveat. When things go wrong, it tends to be much worse. It is not uncommon for me to have a bad set and subsequent high sugars. Then my correction bolus doesn't work, then my new set does work, then that long ago correction decides to work, then you fight off the lows long into the night. Things can get messy. You need to follow a protocol for these troublesome periods which could interfere with your activities.
Michelle Oberg "yep....stop trying to make vegetables taste like meat.....you made your choice, now live with it hippies"

Back on MDI and doing well. Trying Victoza and loving it. A1C 6.0, no major hypos; a few highs; lots of shots. Diagnosed Oct 19th, 1975.
HDL-101; LDL-64; TG-36; TOT-172

#8
Subby

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Yes, xMenace, I find that too. Going off the rails with a pump tends to be a 1 to 2 day period of difficulty for me, and I am beginning to really dread those things going wrong because it is a new type of patience required, compared to just taking another injection or two to get somewhat back on track in 4-6 or so hours, as it used to be. (and that used to take enough patience as it was!)

I am a youngun at it and I need to keep working on those protocols you mention. Yes, certainly, the pump requires a lot of effort and ongoing self education. If you are up to the challenge and can stay positive, it's undoubtedly worth it IMHO.
20 years T1. NPH and Novorapid.
Some essentials for my blood sugar control: dosing via i:c ratio and cf • basal testing when needed • daily 40 minutes moderate exercise (or close) • carbs somewhere below 120g currently • only eating carbs and carb/fat combos that do not cause a problem spike, with or without insulin.




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