[qtrchicken]

I have been a Type 1 diabetic for almost 19 years. Like most of you, I've had ups and downs. For the last 3+ years, my endo has been suggesting that I switch to a pump. I have researched and weighed all the pros/cons and am still not sure if it's right for me. I'm currently on Humalog/Lantus combo. It works ok for me and my A1C's are usually good.

I'm very active and that's what's giving me some pause. I play basketball 3 times a week, work out 3x a week and race a motorcycle during the warm months. I check my blood often, but am considering the Medtronic pump with the CBGM wireless piece. It seems like it would make life simpler for me. I'm concerned about the activities and the pump interfering with each other.

The cost is a factor for me, but my health is worth whatever I can pay. If anyone else has made the switch or has relevant experience, please let me know your thought/suggestions/etc.

Thanks!!

[solox316]

Your sports and activities seem non-invasive enough... meaning I don't think the pump will get in the way too much.

Many many people are very successful and very happy with MDI. I wouldn't be, so I am very pro-pump.

I would say, if you are happy and you have good readings, no reason to switch. But if you want tighter control that you can't seem to reach, and more control over variables (particularly large amount of exercise) a switch might be good.

The CGMS won't really make life simpler, it takes a lot of work/tweaking to get it accurate. It doesn't save on fingersticks for the most part. The CGMS can help you tweak your control...

[xMenace]

Flexibility and control.

Flexability: I can sleep in till noon. I can skip any meal. I can eat whenever I want to. Grazing is not only possible, but it's evil!

Control: I went from a 7.3 to 6.5 in 6 months. Since deciding to not consult with my health team on tweeking it, I've dropped to 6.0% far many fewer hypos and far less serious. You will lose awareness eventually.

Activities: If Toby can do it, I don't know why you couldn't.
YouTube - Toby Petersen

[RobiJo]

There are plenty of folks out there that wear pumps and are very active. Watch the youtube link in xmenace's post. There are sports harness' you could wear or just disconnect. One of my best buds has beat the living daylights out of his pump and it still works fine. He regularly jumps off cliffs, skydives, bungee jumps the list could go on.

The biggest change for me when I switched: the freedom. I could sleep in and and eat when I was hungry; rather than when my insulin said I had too. The CGMS is pretty cool too though not perfect yet.

[BlueSky]

Get one on loan from a pump company and see if you like it.

[Subby]

If it's just the activities that gives you pause, I think you should go for the pump. Variable basal rates and the ease with which you can cater for activity far outstrips MDI. With the lack of long acting insulin in you, you can completely change your basal profile within the next few hours, for as long as you want, easily.

So, going to play basketball in an hour? Dial up a temporary basal of 80% for 4 hours (or whatever works for you with a bit of trial and error), and after you have experimented a little and gottne a handle on the best variables, you will find it minimises the impact of excercise on your BG.

After 15 years MDI, (although it has to be said I found it a lot more tricky than you seem to find it), it was a revelation to be able to be so flexible with insulin delivery and I hope never to have to go back. At the same time, it does take some effort to work with the pump, so if you feel "eh, who cares about it, MDI's good enough" at all, keep thinking twice about it.

The loan Bluesky mentioned would be good, if it's possible.

One last thing... researching and thinking about pumping simply doesn't give you any kind of feel for how it really is (for better or worse). So at some stage if you do want to try it, you will simply need to stop thinking about it, and just take the plunge.

[fgummett]

Even if you can't work out a loaner, I recall I had a 30 day money back guarantee when I bought my first MM... so you can try it out without risk

It may be an oversimplification, but I compare Pumping to MDI in this way: Imagine a truck that makes a daily trip down a twisting, gravel, potholed, mountain road with steep drops off to either side of the road. Now imagine that you get to set the speed once before the trip starts (basal rate) and only get to alter the steering once before each major bend in the road (meal bolus). Wouldn't you rather have more access to the accelerator, brake and steering wheel... that would be the pump You can set multiple automatic basal rates for different times of the day and than change them on-the-fly for example, when exercising. Because you are only using fast-acting insulin your control is much greater both for increasing the amount of active insulin AND for decreasing it. You can set a bolus that is spread over time for example when grazing at a wedding buffet. But it does require more work, is expensive and of the infusion fails for whatever reason (many safeguards built in) you can quickly lose you basal insulin.

[qtrchicken]

I wasn't expecting any responses this quick, but thank you to all who have responded. I will watch the video today.

Here's my endo's theory. I am an engineer that designs and develops software. So, he thinks it would be not only easy, but also very interesting for me to use and tweak. He keeps telling me that I could get my A1Cs in the 5's consistently and not have to worry as much with nighttime lows and lows while participating in high stress activities.

I attended a pump-info class at the hospital facility last month and there were a lot of choices. I've had my mind set on the Mini-Med from Medtronic, but have no experience to rely on besides the features. Does anyone have any reason I shouldn't go with the Mini-med? Otherwise, I'm calling next week to give my approval.

[fgummett]

Well that settles it... I also write software and if you are even a fraction of the geek I am, then you are going to want all the latest hi-tech toys

But seriously, your background should make it easy for you to adapt to the pump, if you do decide to go that way. Best of Luck!

[qtrchicken]

I'm probably more than just a fraction of a geek, but refuse to admit it. ) I have 4 running pcs within arms reach with Linux, XP, etc.

fgummett - I'm not that experienced with Type 2, but why would you be on a pump with type 2? I guess it must be a serious Type 2. Several extended family members have type 2 in my family, but I've never been able to connect that to my type 1. I'm sure genetically there is a connection, but research doesn't seem to suggest that connection.

Anyway, the more I've thought about it over the last few months, I'm getting frustrated with sneaking away for shots at every meal, etc. And the nightly falling asleep on the couch - only to have to get up, test and take Lantus has grown really tiring.

I think in the beginning, I will end up taking more "pump holidays" until I get it completely running precisely.

[fgummett]

Originally Posted by qtrchicken

I'm probably more than just a fraction of a geek, but refuse to admit it. ) I have 4 running pcs within arms reach with Linux, XP, etc.

fgummett - I'm not that experienced with Type 2, but why would you be on a pump with type 2? I guess it must be a serious Type 2. Several extended family members have type 2 in my family, but I've never been able to connect that to my type 1. I'm sure genetically there is a connection, but research doesn't seem to suggest that connection.

Sounds like a geek to me

My specialist started me on insulin within my first year as we both felt it would give me the best control for a long and healthy life. I started on MDI but not too long after (being a geek myself) learned about the pump... I have not looked back yet and have great control

As for being the "serious Type 2" there is a whole other thread about that discussion

[shades9323]

Originally Posted by xMenace

Flexibility and control.

Flexability: I can sleep in till noon. I can skip any meal. I can eat whenever I want to. Grazing is not only possible, but it's evil!

Control: I went from a 7.3 to 6.5 in 6 months. Since deciding to not consult with my health team on tweeking it, I've dropped to 6.0% far many fewer hypos and far less serious. You will lose awareness eventually.

Activities: If Toby can do it, I don't know why you couldn't.
YouTube - Toby Petersen

You can do all those things on MDI too!

[qtrchicken]

So, one person is in favor of MDI. I can respect that, but what are the arguments to stay on MDI?

I've been talking to the rep at Medtronic and she has me a bit worried about the CGM system. Not that it doesn't work, but I may not necessarily qualify for it. First you must prove that you check your blood with a monitor at least 6 times/day on average. I'm close to that, but can't guarantee it. I'm definitely not buying it outright. It's rather pricey at the street price. Not to mention that the monthly costs outside of insurance are just ridiculous.

I've looked at the Dexcom too, but that's a completely different system. They demo-ed it for me at the info session. The guy had the dexcom along with the Medtronic mini pump. I like the Dexcom CGM system as it has a ton of checks/measurements and very good alarms. That's what I really find the most appealing about any pump. The ability to be notified if things are out of my set boundaries, seems like an excellent tool.

[fgummett]

some MDI advantages:

* much cheaper
* not tied to a pump 24/7/365
* less chance of DKA [so long as you remember to give your long acting basal]
* possibly don't need to test quite so often
* don't need a degree in computer science to program it
* supplies are more likely to be available Worldwide
* no annoying beeps or alarms going off at odd moments
* as a man I would not need to shave patches of my belly every three days
* ... I'm sure there are many more...

[qtrchicken]

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