[shades9323]

I am in favor of using what works for you. I am an MDI user, more due to cost. I would love to try a pump. I like gadgets! But my insurance sucks for DME. Both methods do the same job. To combat any exercise lows from having a not variable basal, I just eat extra carbs. I like to eat.

[fgummett]

Originally Posted by qtrchicken

fgummet - are you changing your allegiance? I thought you were in favor of the pump vs MDI?

Not at all... along with just about everyone who has tried a pump you would have to, "pry it out of my cold dead hands". Just trying to be helpful. The cost is certainly a big consideration especially if you don't have insurance $7-8,000 just for the pump and then around $250 per month for supplies. Even more if you also go with CGMS. You need to test probably in the order of 8 - 10 times a day or more, especially when first starting out on the pump and by all accounts it is more work than MDI... although it really doesn't feel like it
I'm hoping you'll get some other feedback here but if not please search and read around on the forum as I know there are different opinions on this. For example I understand that some do not feel that the extra effort and cost are justified for what may be a small improvement in control.

To be Frank (hah!) I can list the advantages of MDI and still know I am better off on the pump... my insurance did not cover the replacement pump I just got so I am out of pocket nearly $7,000 what does that tell you?!

[rzrbks]

My CDE has been after me to switch to pump for 5 years now. I haven't because:

1) Worst A1c has been 5.9

2) Cost, Cost, Cost and Cost

3) I don't want to be tied down 24/7

4) Cost

5) I bolus much like pumpers which is why I keep A1cs in 5.5--5.7 range

The most important thing, however, is that you have to do what's best for you.

Unless and until my control goes to $%#%^$, I'll stick with my MDI.

I have to let you know that I'm still using my InDuo even though the non-replaceable batteries died a year or more ago. The injector works just fine without the batteries.

If I was only able to use a regular pen, I MIGHT think more seriously about about switching except for COST.

[shiftzor]

Originally Posted by fgummett

To be Frank (hah!) I can list the advantages of MDI and still know I am better off on the pump... my insurance did not cover the replacement pump I just got so I am out of pocket nearly $7,000 what does that tell you?!

Lol, that you are now extremely poor, living under a rock in a cave, somewhere remote, growing a beard and wondering where it all went wrong.

I am asking the same question (as an MDIer) and currently I am pro pumping. Getting one might be harder said than done. I have yet to properly research it but I will do . Good luck with your quest.

[qtrchicken]

My insurance provider does cover the cost of the pump, supplies, CGM and accessories. I couldn't justify it, if I had to pay out of pocket. It will run me about $700 to get the pump with my insurance. Not sure about monthly costs, but they won't be too much more than what I'm paying now. (that's all relative)

In the end, if I don't like it, I can always switch back without too much drama. I see my biggest hurdle as the bolus calculation. I've never really figured out my Insulin to Carb ratio. I guess it's time to start counting and get a baseline.

[xMenace]

Originally Posted by qtrchicken

In the end, if I don't like it, I can always switch back without too much drama. I see my biggest hurdle as the bolus calculation. I've never really figured out my Insulin to Carb ratio. I guess it's time to start counting and get a baseline.

Generally it's incorrect basals that make things difficult. Focus more on basals first. Once they are set accurately, bolus ratios pretty much fall into place.

[shades9323]

Originally Posted by qtrchicken

My insurance provider does cover the cost of the pump, supplies, CGM and accessories. I couldn't justify it, if I had to pay out of pocket. It will run me about $700 to get the pump with my insurance. Not sure about monthly costs, but they won't be too much more than what I'm paying now. (that's all relative)

In the end, if I don't like it, I can always switch back without too much drama. I see my biggest hurdle as the bolus calculation. I've never really figured out my Insulin to Carb ratio. I guess it's time to start counting and get a baseline.

You should have yout I:C ratio worked out if you are on a pump or mdi. It is very important to have these right no matter which method you prefer.

[Subby]

Originally Posted by shades9323

You should have yout I:C ratio worked out if you are on a pump or mdi. It is very important to have these right no matter which method you prefer.

True, but at the same time, as control sounds pretty tight already, if going for the pump, the transition onto the pump would be a fine time to work all that stuff out - it's really not that complex anyway. I found its a lot easier to tinker with getting I:C ratio right, armed with a pump. For a start you can experiment with smaller sized carb amounts and multiple extra boluses through the day, without having to resort to a lot of injections, and with a much bigger chance of very similar absorption, at least while on the same set (usually 3 days).

[Blibbit784]

I am going with Minimed, starting Monday. The trainer is helping with my ratios as I am brittle and have poor control on injections. She also tells me the pump has only a 3% margin of insulin that may not be absorbed or used properly, but with injections you may not get up to 50% since it is subcutaneous.

[Subby]

Originally Posted by Blibbit784

I am going with Minimed, starting Monday. The trainer is helping with my ratios as I am brittle and have poor control on injections. She also tells me the pump has only a 3% margin of insulin that may not be absorbed or used properly, but with injections you may not get up to 50% since it is subcutaneous.

That 3% may be true in some clinical study, but be aware that there are quite a few factors that might significantly affect absorption, including: set type, area of body used (for example I have a few cm circle on my belly that doesn't work well, or it may be large areas), how well the cannula is "seated" in the hole etc etc. Many of these issues may not crop up at all, and if they are present they can be dealt with, for example by trying a different set, or keeping track of where you get good results on your body. But, being aware of them is the first step, so keep it in the back of your head if you find absorption does vary a lot more than you would expect.

Congratulations on the move, I predict you'll feel a whole lot better soon like me, and your health will improve the more you synch with the pump. Took me a good 6 weeks to feel I had a real handle on it, and thats kind of time frame seems to happen for other people, so take it easy and hang in there. Don't forget the pump forum here, we're all here learning together and there's lots of experienced pumpers around.

[MJM]

I have friends who are triathletes and pump users. They have the pump because it facilitates greater control. If you start to go low you can reduce your basal instantly or even stop it, if necessary. It allows for night-time basal adjustments to meet your needs. In other words, greater control and greater flexiblilty.

[Gary_W]

Originally Posted by Blibbit784

I am going with Minimed, starting Monday. The trainer is helping with my ratios as I am brittle and have poor control on injections. She also tells me the pump has only a 3% margin of insulin that may not be absorbed or used properly, but with injections you may not get up to 50% since it is subcutaneous.

Excuse me for being dense, but can you explain this to me a little more in depth please?

I used to whack an 8mm long needle into me. Now I have a 6mm teflon tube sticking in. Are you saying that the 6mm tube is not subcutaneous? I know that you use less insulin on a pump, but further details on this would be welcome

So as not to pinch the thread totally, I'm a 100% pumping convert. Just over 3 weeks in and you would have to threaten violence to get me back to MDI. And even that might not work...

[solox316]

Originally Posted by Gary_W

Are you saying that the 6mm tube is not subcutaneous?

I am curious about this too... I was always under the impression that infusion sets are sub-q...

[Lloyd]

Originally Posted by qtrchicken

fgummett - I'm not that experienced with Type 2, but why would you be on a pump with type 2?

For one thing, if you have Dawn Phenomenon, it is far and away the best method to manage it.

I have 9 different basal rates, ranging from 2.8 U/hr at 2 AM to .65 units/ hr at 2 PM.

The ability do do this has dropped my fasting readings from 180 - 220 down to the current 80 -110.

It took effort and trial and error to get this all set up, but you can see the results below. 90 average glucose, and also a 90 average fasting glucose.

-Lloyd

[Blibbit784]

Folks, I am sorry about the confusion here, wrong choice of words. I spoke with the trainer and she said that the pump allows insulin infusion in small amounts between the cells (interstitially) Def.
2 a: situated within but not restricted to or characteristic of a particular organ or tissue —used especially of fibrous tissue b: affecting the interstitial tissues of an organ or part

Yes it is also subcutaneous, injected into the fluid between the cells.
She said when you put a large amount of insulin, say, your twelve hour dose by injection it pools in your system. The amount actually used can be lower because of pooling. A basal rate allows small doses just like the pancreas so it is absorbed better. She said there were other factors like hormones that could affect your insulin absorbtion, and that insulin injections are mostly guesswork because you don't really know how much you absorb.