[Yvonne Burns]

Hi everyone. I just sent a post to Tokyo Cate responding to a question about the dawn phenomenon but I should have started a new thread instead. So, here I am. My question: Has anyone gone from the pump to MDI? Why? The usual direction is, of course, MDI to the pump. Just curious. Thank you, Yvonne

[Cinnabon]

Yvonne,
I went to my Endo with this question and it was due to me wanting to be on the beach for a few days. THere are some here, that take a break form the pump. If I do go to shots for whatever reason, its simply taking your Basal total (w/ Lantus), example, and the bolus (Novolog). He told me I could do this whenever I wanted a break.

[UpNorth]

I'm taking a break right now actually For me, i just go back to the same Levemir (or Lantus) dose i was on before pumping... it's more or less the same as my pump basal so This is the 2nd break i take (last one was over summer last year), and when taking breaks this frequently i get to know my insulin needs on MDI aswell, without too much fiddling with doses the first days back on MDI My pancreas is totally (confirmed by bloodtests a while ago... no insulin production whatsoever) i've only been T1 for one year, 6 months and 10 days as i know of But i prefer it this way really- with completely dead pancreas... i had one **** of a honeymoon a while after diagnose

[jen_slc]

Originally Posted by Yvonne Burns

Hi everyone. I just sent a post to Tokyo Cate responding to a question about the dawn phenomenon but I should have started a new thread instead. So, here I am. My question: Has anyone gone from the pump to MDI? Why? The usual direction is, of course, MDI to the pump. Just curious. Thank you, Yvonne

Hi Yvonne, yes, I spent 7 years pumping and then went back to MDI. The first 6 years were great, but the last year it got bad. I had serious problems with scarring despite all my rotating and frequent site changes - all I could use was my stomach/hip/butt area and it got way overused (couldn't get to my arms, legs were unbelievably painful). The scarring lead to a **** of a lot of pain all the time, lots and lots of blood, terrible absorption and bad glucose control. It got to the point where I was scared to change my set. I was very unhappy. So I came off it about 3 1/2 years ago and went to Lantus/Humalog and now I'm on Lantus/Novolog. It was one of the best decisions I have ever made - my A1c is so much better now. The last few months pumping have scarred me for life (mentally more so than physically) and I honestly think I will never pump again. But that's alright by me, I am very happy on MDI! The thought of a set change makes me cringe like crazy!!

[Diana]

I've been pumping on and off since 2001, but have had so many breaks from the pump that I have lost count. As long as you have a backup plan set up, like up north says, you are fine to swap whenever you like. I think even if you plan on continually pumping, its a very very good idea to have a back up plan, just in case the pump ever dies. I dont actually keep long acting insulin in my house, but I do always have an in date prescription for it, so the longest I will ever have to survive with out my long acting is overnight until the chemist opens. It would be a bit sucky to have to give myself a shot every 4 hours or so of novorapid, but its do-able and will keep me alive.

As for why I have switched back and forth.. firstly I hated the pump, and couldnt cope with the insertions. (I now use sets that I can live with) Other times I have wanted to wear something that was not pump friendly. Sometimes I just cant be stuffed doing pump stuff, and consider injections easier for a few days. I live in Australia, where there is a big 'beach culture'- actually, I'm a bit scared of the waves, but if/when I go to the beach, its pump off time. I'm not burying $8000 in the sand for someone to pinch (of course, my new pump is waterproof, but it doesnt coordinate with my bikini). Sometimes I just dont want the pump attached to me, and find that injections give me more 'freedom'. Oh yeah, and I have had my pump die on me.

It looks like I have a lot of complaints about pumping, but in reality I find it good more often than not, or at least the path of least resistance. I just think that its important that people realise that once you put a pump on, you are not attached to it permanently for the rest of your days. Wear it when you want to, inject when you dont.

[Yvonne Burns]

Thank you all for your replies. I recently met up with an old friend from a diabetic discussion group in the early 70's. She looked amazing and has had very few complications throughout all these years. She is on the "pen" and takes Lantus for long acting and Humalog prior to each meal. Her A1c is 6.1. Better than what I've been able to achieve (at least so far) on the pump. We were in a restaurant and she discretely took her insulin right thru her jeans. I put all this on the back burner of my mind. The pump is good for: using very small increments of insulin, being able to vary the basal throughout the day. The pen is good for: not having to wear a "contraption" and figure out where I am going to put it depending on my plans for the day, not having the infusion set kink up and not deliver insulin. What else? Pros and cons of each??? I appreciate this forum for discussion. Thank you, all.--Yvonne

[UpNorth]

+ with pump:
Possibility to set temporary basals when being high or low
Have basal dose set to exactly what's needed in different times of the day
Possibility to take very small bolus doses to correct a high
Possibility to take very exact bolus doses for meals
Freedom
Less needles


- with pump:
More risk for infections due to having the infusion set in for days
More risk of scar tissue due to having infusion at the same place for days
Possibility of getting an allergic reaction of the adhesive
Sets being kinked or yanked out
Only using rapid insulin can cause DKA very fast if something fails with pump
Tubing getting caught everywhere
Not knowing where to put pump
Always connected to something



+with MDI:
Using both longacting and rapidacting insulin
Freedom
Less risk of infections
Less risk of scar tissue
Easier to be discrete about D
No itchy adhesive
No tubing getting caught everywhere
Less risk of failure with insulin delivery
Easy to carry around a pen- fits nicely in all bags or jeanspockets
People's reactions when injecting in public
Probably less expensive than pumping (i wouldn't know, get all my stuff for free)

-with MDI:
No possibility to set temporary basals
No possibility to finetune the basalrate throughout the day
Not being able to give very small bolus doses
More needles- though they hurt way less than inserting a infusionset (and those doesn't hurt either)
Slightly higher risk for hypos






These are my personal experiences... Both pump and MDI works great for me

[Shotokan]

Nice list.

I notice that you put "Freedom" as a + for both the pump and MDI. I know what you mean: different kinds of freedom. With MDI you are free of anything being attached to you. With the pump you have relatively more freedom with eating. For example, you can postpone a decision on whether you will have one or two slices of pizza and just bolus for each slice as you go along, while with MDI you either need to inject enough insulin for two slices or do a second injection later if you decide to have another slice.

[UpNorth]

Originally Posted by Shotokan

Nice list.

I notice that you put "Freedom" as a + for both the pump and MDI. I know what you mean: different kinds of freedom. With MDI you are free of anything being attached to you. With the pump you have relatively more freedom with eating. For example, you can postpone a decision on whether you will have one or two slices of pizza and just bolus for each slice as you go along, while with MDI you either need to inject enough insulin for two slices or do a second injection later if you decide to have another slice.

yep, different kinds of freedom On MDI i can wear whatever i want to wear without having to worry where to put the pump, go swimming without needing to plan it too much, sure, my pump is waterproof, but in summer... well i can live without infusion site tan Or when disconnect *still get infusion site tan if it's in summer* and then needing to go back and connect every now and then to always have insulin in your system. On MDI one always have insulin in the system thanks to the longacting So it really is different kinds of freedom... One of the features i like the most about pumping, is the possibility to take really tiny bolus doses, sometimes 1U is too much

[rzrbks]

yep, different kinds of freedom On MDI i can wear whatever i want to wear without having to worry where to put the pump

See, that's of great concern to me as well. I'm always afraid the my perchant for over-head Décolletage will really make a pump somewhat less than not obvious.




J/K, I know that's a real concern for females