Pros + Cons

[Rachel_1989]

hi 🙂
what would you say the pros and cons are of getting an insulin pump? i am type 1 with insulin resistance an my consultant said last week that the pump may be a better option for me

so, i just was wondering whats the pros and cons from people who already have the pump 🙂

 

[Ellie Jones]

You have to remember I am baised about pumping lol..

Pros

No multi injections per day (cannular need changing every 48-72 hours depending on type used)

Fine tuning in doseage, both basal and bolus wise....

Better control, tighter control does make you feel better over-all improved energy levels...

Most pumpers find reduction in TDD

More proactive and time reactive..

Always go your insulin on you..

Wizards arevery helpful with dose and corrections enable better control..

More flexability on day to day bases..

Con's

For me not any...

But if you are self funding it's exspensive..

But the best advice I can give..

Try it, if it isn't for you, you can hand it back and return to MDI...

 

[Northerner]

I don't pump, but I recognise the huge benefits most people can get from them, as outlined by Ellie above. Some cons might be:

Conected 24/7 to the device - on MDI you just inject then you're done till the next time.

Pump failure - whether a mechanical failure or a kink in the tubing, this can stop any insulin getting through to you, the pump provides your basal insulin as well so without it your levels can rise very quickly.

Extra stuff to cart around - With MDI you need to carry your pens with you, but if going away for a few days, for example, you need to carry spares of everything for the pump, plus your pens as a backup.

Filling up reservoirs - no idea how easy or difficult this is, but some people report problems with bubbles. Cartridges rarely need any effort.

 

[bev]

hi 🙂
what would you say the pros and cons are of getting an insulin pump? i am type 1 with insulin resistance an my consultant said last week that the pump may be a better option for me

so, i just was wondering whats the pros and cons from people who already have the pump

GET ONE GET ONE GET ONE GET ONE GET ONE GET ONE GET ONE!!!!!!!!!!!!!!!!

If you have the opportunity to have a pump - grasp it with both hands. Lots of people are fighting to get a pump as it is recognised that control is much better and for many other reasons. There are children on the other forum that I am on have been fighting for years to go on the pump - so if your team are offering you one that shows that a) they are a good team and b)they recognise that you will benefit from pump useage.

My 12 year old son has been on his pump for 1 year now and his hba1c was 9.6 on MDI (with a lot of hard work) and 3 months after being on his pump it was 7.1% - that speaks volumes.

He would not give his pump back for anything - EVER.

He is very insulin sensitive and the pump can do 1/40th of a unit - we were never going to be able to do that on MDI - so this is the best all round. We also use a cgm with our pump that tells us his BG every 3 minutes which makes life easier and means we can avoid hypo's and hyper's before they happen.

Downside. You are at slightly greater risk of ketones and DKA as you dont have background insulin to help out - so if the pump fails you have to revert to injections. But this is not a common event and most people who pump are aware of this and take action quickly. We carry a spare injection with us everywhere we go and very rarely have to use it.🙂

You are wearing it 24/7 and for some people this can be a problem. My son and his friends who have pumps says that they dont even notice its there anymore and feel lost when they take it off for a shower.

If you like sports and exercise you can reduce your basals to very low amounts to avoid hypo's - so it stops you having to fill up on junk food to enable you to do exercise which seems a waste of time. Alex does a 50% for a very long bike ride and avoids any hypo's which is great. He couldnt do that on MDI - we were always feeding him mars bars and coke etc.

It is much easier to give yourself insulin when in public places as the pump looks like an ipod or similar and nobody even notices what your doing. You can get pumps with a remote control so you dont even have to be holding your pump to have any insulin.

Pumps are always changing and there are always new ones on the market - they are getting smaller and smaller and the technology is advancing all the time.

I know hundreds of people on the other list (children) who are on pumps and I know of one child who gave the pump back in favour of MDI - and that was for very personal and very reasonable reasons - nothing to do with the effectiveness of the pump - and he has just recently decided he wants to try it again.

Most people find their insulin requirements drop by approximately 25% when using the pump.

I honestly cant think of many bad things about the pump - but we are biased as we prefer the pump.

You can always give it a go and see how you like it (dont tell your team that though) and if you really hate it (doubt it) then you can give it back and go onto injections. I would also say that with all this GP commissioning, it may not be on offer so easily in future - so while it is you should take the opportunity and try one.


Let us know what you decide.🙂Bev

 

[bev]

I don't pump, but I recognise the huge benefits most people can get from them, as outlined by Ellie above. Some cons might be:

Conected 24/7 to the device - on MDI you just inject then you're done till the next time.

Pump failure - whether a mechanical failure or a kink in the tubing, this can stop any insulin getting through to you, the pump provides your basal insulin as well so without it your levels can rise very quickly.

Extra stuff to cart around - With MDI you need to carry your pens with you, but if going away for a few days, for example, you need to carry spares of everything for the pump, plus your pens as a backup.

Filling up reservoirs - no idea how easy or difficult this is, but some people report problems with bubbles. Cartridges rarely need any effort.

Agree with everything Northey - apart from carrying extra things around. The pump is attached - so you dont notice its there. We carry an injection and hypo treatment - like we did on MDI - so no different. The only 1 difference is that I choose to carry a set change which is 1 very small package and an inserter - the size of a finger pricker. I dont really have to carry this as we have the injection pen as back-up - but I feel happier having one with me. When Alex is out on his own he just carries an injection and hypo things - the same as he did before pumping.

Fillling reservoirs is an art and once you have mastered it then its very easy. We dont get many problems doing this now - I think its a trial and error thing.🙂Bev

 

[bigpurpleduck]

Hi Rachel,

I can't really add much to what's already been said. However, I would say that despite some of the cons (i.e. being permanently attached, occasional problems with sets causing high BG) I've found pumping to be FAR superior to MDI for control. My A1c has improved greatly, life and diet are much more flexible and I feel soooo much better since starting on the pump. I've got much more energy. I used to get regular bouts of thrush and cystitis when on MDI beause of high BG, but since I started pumping I've rarely experienced either. Also, I've suffered from colds and other viruses a lot less. Result!

So anyway, would highly recommend!

 

[Adrienne]

I don't pump, but I recognise the huge benefits most people can get from them, as outlined by Ellie above. Some cons might be:

Conected 24/7 to the device - on MDI you just inject then you're done till the next time.

Pump failure - whether a mechanical failure or a kink in the tubing, this can stop any insulin getting through to you, the pump provides your basal insulin as well so without it your levels can rise very quickly.

Extra stuff to cart around - With MDI you need to carry your pens with you, but if going away for a few days, for example, you need to carry spares of everything for the pump, plus your pens as a backup.

Filling up reservoirs - no idea how easy or difficult this is, but some people report problems with bubbles. Cartridges rarely need any effort.

I'm gonna answer this cons Northerner :

Conected 24/7 to the device - on MDI you just inject then you're done till the next time

Yes but if you go hypo you can in theory stop the insulin going in but with injections it is already in ! Also for sport coming up you just adjust the basal levels (background) lower to compensate but with MDI it is already in you !

Pump failure - whether a mechanical failure or a kink in the tubing, this can stop any insulin getting through to you, the pump provides your basal insulin as well so without it your levels can rise very quickly

This is true but quite rare but you always have your pens as a back up. You don't often get a kink, Jessica has never had in almost 4 years. Yes levels can rise quickly but generally you are alerted to this and you deal with it.

Extra stuff to cart around - With MDI you need to carry your pens with you, but if going away for a few days, for example, you need to carry spares of everything for the pump, plus your pens as a backup.

Its not much really and the benefits outway the very light extra load.

Filling up reservoirs - no idea how easy or difficult this is, but some people report problems with bubbles. Cartridges rarely need any effort

This is purely user error and it is practice, practice, practice which makes perfect. There is knack to it and once you have it, you never look back.

😉

 

[bigpurpleduck]

Adrienne, I love you and your pro-pumpness!

 

[Northerner]

Thanks to Adrienne and bev for elaborating on my perceived 'cons'! 🙂

 

[Rachel_1989]

wow thanks guys! lots of pros there 😉 and most of the cons i could live with but the main concern i have is if i can have something attatched to me 24/7 .. im sure id get used to it. but definatly i think i will talk to my consultant next time i see him (i see him 3 monthly at the moment). but my dr is very 'pro-pump' as he said last week so think he would pursuade me to get the pump too if he thought it was best for me.

my dsn told me that if i do think pump option is for me then they can set up a trial with the pumps they have in clinic too..which would answer the question whether i could cope with something with me all the time.

i have a brilliant team now ive done DAFNE and have lots of support from my new DSN my next appointment with consultant at hospital is around december i think so have lots of time to think i suppose 😛

 

[Adrienne]

Thanks to Adrienne and bev for elaborating on my perceived 'cons'! 🙂

Hehehehe no problem there Northerner, you just know you won't win this one with us two here ........ 😛

 

[Adrienne]

wow thanks guys! lots of pros there 😉 and most of the cons i could live with but the main concern i have is if i can have something attatched to me 24/7 .. im sure id get used to it. but definatly i think i will talk to my consultant next time i see him (i see him 3 monthly at the moment). but my dr is very 'pro-pump' as he said last week so think he would pursuade me to get the pump too if he thought it was best for me.

my dsn told me that if i do think pump option is for me then they can set up a trial with the pumps they have in clinic too..which would answer the question whether i could cope with something with me all the time.

i have a brilliant team now ive done DAFNE and have lots of support from my new DSN my next appointment with consultant at hospital is around december i think so have lots of time to think i suppose 😛

Well I think you have answered your question yourself now. You have to try it to see if you can deal with being attached. From what I can see and have heard it just becomes part of you. My 10 year old has it loose in bed with her (which obviously may be different for an adult) but I have seen her get out of bed, tuck the pump under the arm and go to the loo and get back into bed and she thinks nothing of it at all.

Amazing

 

[bigpurpleduck]

wow thanks guys! lots of pros there 😉 and most of the cons i could live with but the main concern i have is if i can have something attatched to me 24/7 .. im sure id get used to it.

Being attached 24/7 was my main concern before I started pumping. I'm really quite vain and didn't like the idea at all.

I'll admit it did take a bit of getting used to. Sleeping at night was difficult to begin with for fear of knocking it or pressing buttons, but I quickly found a way of wearing it which means I can lie in any position I like. I was also scared of the sticky bit around the cannula coming off in the shower, but this has never happened. The pump, set and cannula are MUCH sturdier than you'd expect.

My view on wearing the pump has changed completely since I started pumping. Because wearing it has made such a huge difference to my life, I actually LIKE wearing it now. I'm proud to have it on my belt, and proud to take it out for boluses. It sounds ludicrous, but I actually love my pump as though it were a person. It's absolutely amazing.

 

[sugarfreerach]

Ive been on a pump for 2 years now, went from HBA1C of 12.3% down to 8% in 3 months and then now HBA1C of 7%. at first like you i was nervous about having it attached to me at all times but there are loads of places you can wear it without being seen and honestly you forget your wearing it. I even stand up and walk off and only realise ive left it behind when its trailing behind me (when its not in my clothes etc)

The connection sites are studier than you think and they've taken a good few pulls when ive got it caught on the door handles (again when im not wearing it close to my body, which i do most of the time but around the house i tend to stick it in my hoody pocket)

The only annoying thing i find is the changing of the cannula but i hate needles so it is much much better than having to inject 4 times a day!!

OOh and when the insulin needs changing the alarm goes off when you have 20 units left, its annoying if its the middle of the night, but at least that 20 units gets you through til the morning.

I would honestly say go for it, it has changed my life, it has helped me gain control! Its allowed me to snack (which i love) as i dont have to have a 1 unit (if an apple) injection each time, i just get percival the pump out and give myself a unit.

GO Go GO!!

 

[tracey w]

I don't pump, but I recognise the huge benefits most people can get from them, as outlined by Ellie above. Some cons might be:

Conected 24/7 to the device - on MDI you just inject then you're done till the next time.

Pump failure - whether a mechanical failure or a kink in the tubing, this can stop any insulin getting through to you, the pump provides your basal insulin as well so without it your levels can rise very quickly.

Extra stuff to cart around - With MDI you need to carry your pens with you, but if going away for a few days, for example, you need to carry spares of everything for the pump, plus your pens as a backup.

Filling up reservoirs - no idea how easy or difficult this is, but some people report problems with bubbles. Cartridges rarely need any effort.

All you have said is true, but I dont find any of those reasons to be a problem for me. Just been away and took extra stuff etc but I probably would have took as much on mdi too 😉

You get used to filling cartridges and getting rid/checking for bubbles. Yes you need to check more often but again I check quite regular, as drive often, exercise etc, so not a problem for me anyhow.

As for being attached, I wouldnt be without it and have felt like that since i first attached it, just part of me now!

 

[Ellie Jones]

One way of getting some drift what it's like to wear a pump, is one mobile phone, piece of string about 60cm (standard tube length) and some sticky tape (Yes I did watch Blue Peter as a kid🙂:rolleyes attach one end of string to mobile and tape the other end onto stomach and a way you go..


My pump roams at night, and it's has no problems with sharing my bed with hubby as well, it does make a very good anti-snoring device hehe...

Having the pump for me does mean most of the time I actually carry less kit with me, I only carry my insulin pen if I know that I can't get home quickly... Work is only 10 minutes away... So carry a spare infusion set in my meter case... On MDI I generally had to carry both quick and background pens with me, due to the timing of my split dose...

I actually sobbed my heart out after being on the pump for a week and very emotional for a couple of days, but I was just so over-whelmed with how much energy I had, how well I felt in myself and not having suffered one single hypo for a whole week was sheer bliss.. I had been for several years suffering 2-4 hypo's a day...

Now I rarely suffer a hypo, perhaps not even once a week, they aren't as anywhere near as aggressive as they used to be, a lot quicker to get back to norm.. My Last HbA1c was 6.7% as it contained a blip a bad couple of days of control and bad now adays for means hitting the 8's! And I actually achieve this without the aid wizards that most pumps have.. For me it out wieghs the worry of DKA..

 

[tracey w]

One way of getting some drift what it's like to wear a pump, is one mobile phone, piece of string about 60cm (standard tube length) and some sticky tape (Yes I did watch Blue Peter as a kid🙂:rolleyes attach one end of string to mobile and tape the other end onto stomach and a way you go..


My pump roams at night, and it's has no problems with sharing my bed with hubby as well, it does make a very good anti-snoring device hehe...

Having the pump for me does mean most of the time I actually carry less kit with me, I only carry my insulin pen if I know that I can't get home quickly... Work is only 10 minutes away... So carry a spare infusion set in my meter case... On MDI I generally had to carry both quick and background pens with me, due to the timing of my split dose...

I actually sobbed my heart out after being on the pump for a week and very emotional for a couple of days, but I was just so over-whelmed with how much energy I had, how well I felt in myself and not having suffered one single hypo for a whole week was sheer bliss.. I had been for several years suffering 2-4 hypo's a day...

Now I rarely suffer a hypo, perhaps not even once a week, they aren't as anywhere near as aggressive as they used to be, a lot quicker to get back to norm.. My Last HbA1c was 6.7% as it contained a blip a bad couple of days of control and bad now adays for means hitting the 8's! And I actually achieve this without the aid wizards that most pumps have.. For me it out wieghs the worry of DKA..

What a lovely, positive post! I can relate to feeling so much better almost overnight when i started pumping too. 🙂

 

[rossoneri]

It is good that people are being positive on this thread. If I may though I would, as a pump user, like to highlight one or two further cons.

First of all you may want to take a look at this earlier thread on the General Message Board which had more of an input from those not on pumps.

I think on a pump although it is true that overall your control is likely to improve, witness the improvements to HbA1c levels outlined here, when things do go wrong you are more exposed to suffering sudden sharp rises in your BG level and consequently also to getting Ketones than you are on the MDI regime. I think this is because the long acting basal insulin, Lantus or whatever, does provide a better safety net against sudden rises in BG levels than the pump's basal of continuous small doses of short acting insulin. These occasional sudden rises in BG levels and even the Ketones are not a cause for concern if they only happen very occasionally and are quickly dealt with but they are something to be aware of.

I also think that because of this exposure to sudden rises in BG levels you do have to be stricter about regular BG tests. Although I tested regularly whilst on MDI there were times when I felt I could take a half day or even a full day's break from testing because I felt the consequences were somewhat limited because of the safety net the long term insulin provided. With the pump I feel obliged to test all the time and more regularly. Since moving onto a pump I test on average about 7-9 times a day compared to say 5-7 times on MDI. Taking more care is generally a good thing anyway but it is something you should be aware of when considering moving to a pump, especially if you are a reluctant tester.

A similar consideration on the pump is that the carb counting becomes more involving too. Again I carb counted on MDI. But on a pump you are providing an insulin dose for every snack. This does give much greater flexibility but it can require a little extra work and more flexibility can lead to more temptation - all those high calorie snacks become just a little more feasible!

Finally I would not underestimate the amount of effort required with getting started on a pump for the first time, getting your doses correct, becoming accustomed to doing the catridge changes and inserting the pump needles etc. It can appear particular difficult if you have been on injections for a long time prior to going onto a pump (I had been injecting for over 20 years) as you will be comfortable with the injection regime despite the problems it may be causing you.

Having said all that I have no regrets about moving to being on a pump regime and it has certainly helped to improve my control even though it was quite good under MDI. I would also say that one of the main advantages of pump therapy is that it does reduce your total daily insulin intake so this should suite your insulin sensitivity. 😎

With that I shall await the backlash from Adrienne and bev for daring to not be entirely in the pro camp! 🙄

 

[Northerner]

Thanks rossoneri - Rachel did ask for the cons as well! I think it is very useful to have this discussion as some of the 'cons' may be misconceptions and some may be more of a consideration to some people than others. It would appear that the 'pros' are universal, which is encouraging for those of us that are on the fence - not that I'd have a snowball in hell's chance of ever getting a pump!

 

[bev]

With that I shall await the backlash from Adrienne and bev for daring to not be entirely in the pro camp!

He he - you wont get one! Its great to hear the views of an adult pumper. As parents of diabetic children, we obviously dont *feel* what a diabetic person would feel.

My perceptions of using the pump are entirely as a spectator, and as such, doesnt even compare with someone who actually wears a pump.

You are absolutely right when you say that you need to test more on the pump - but on MDI we were testing an awful lot as we just simply didnt get any kind of control - so mostly lived off 'corrections' - so in fact - I think we have reduced our testing.🙂

We carb counted almost from day 1 - so we dont know any other way of doing things. I do agree that you have to be more accurate with your carb counting on the pump and we have found that Alex has even more ratio's than when on MDI as we now *know* that certain times of the day he is more insulin resistant - whereas on MDI we just couldnt see the wood for the trees because the lowest increment we could do on the pen was half a unit - not good when your child is insulin sensitive - so we really didnt stand a fighting chance of ever getting things right on MDI. It always astonishes me that even if Alex is having a very low carb treat like a sweet at only 2 carbs that we can give insulin for it - unheard of on MDI - which did limit his food intake and he was underweight for quite a few months because he could never have the so-called 'free carb' of 10grams mid-meal or that 1 sweet as a treat. Now he can eat what he wants when he wants and has started to put on some weight (in the right places).

The pump is hard work - no doubt about that. If you dont put the effort in you dont get the results. But it is a ?3000 piece of kit and it would be such a waste if you just plugged it in and left it to its own devices. It really is only as good as the user.

Alex has had borderline DKA once since being on the pump (1 year) and this was entirely due to having 2 bent canulas one after the other - extremely rare and unheard of when I rang medtronic. Adriennes daughter has been pumping for years and never had this - so I do think we were just unlucky.🙂Bev

p.s. I forgot to mention that pumps come into their own if there is an illness which sends levels high. Alex has been on 400% basals and Adriennes daugher has been on 800% when they have been ill - this would be almost impossible on MDI as once you have injected - you cant take it back - but you can alter the pump every hour. (sorry - I just couldnt resist getting another one in - he he).