pump or change diet??

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breeze

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Hello, I have been a type 1 diabetic since I turned 6 years old, so 30 years now. I have been injecting myself all of my life and am not bothered by this at all. But, for the last few years I have really been trying to get ontop of my control (with the help on and off from a dietician) . My hba1c has always been on the high side, around 8.something and certain foods which are a major part of my diet seem to cause me problems with highs in the mornings. These main problem foods are pasta and rice (and pizza which we have sometimes). Last night my wife and I had pasta at about 8pm, I split my insulin dose to part before and part after. My levels stayed at about 6 all evening, even when I went to bed at about 11.30pm. Then I wake up this morning to find I'm 18!! This happens a lot.
So, my main question is will a pump help me with this inconsistency? It is rare that I have a day where my levels stay within the desired range.
My wife says that i should really look into this as she want to keep me around for a bit longer! 😉
We are based in s.wales. does this make a difference to the wait times? I have noticed some of you have had to really work hard to get your pumps.
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Thank you for reading!
 
Hi Breeze,

A pump can help deal with foods like pasta and pizza which can take hours to digest. You can split the insulin dose, taking part upfront, and the rest spread over several hours. If my son is eating a meal quite high in fat e.g. pasta in a creamy sauce or pizza, he can also run an increased basal rate for several hours afterwards to help combat a rise in his BG levels. I'd recommend a pump to anyone as it's a fantastic tool, not just for pasta/pizza! My son's Hba1c's were also mostly in the 8's pre-pumping, but have all been 6.9-7.4 since, especially with being able to tailor an exact basal profile for him.

Since you ask the question "pump or change diet?", can I suggest you also experiment with changing the timing of when you have these foods (don't give them up if you enjoy them). I do find that these longer-digesting foods are much easier to manage diabetes-wise when eaten for lunch instead of in the evening. Alternatively, try and leave a longer gap between evening meal and bedtime. 🙂
 
Hi ! Like you i am a long term T1, was on injections & now been on pump for a few years. A couple of things, i like pasta but pizza 😱. To many carbs for what you get. (allways hungary). I think a pump is the best so far & would get your name down for one. 🙂
 
Hi Breeze 🙂 I have had a pump for two and a half years now, it really is life-changing. I got mine up in Aberystwyth but have recently moved to Newport and am in the process of finding a new hospital which will fund my pump (else I'll have to give it back!) I have been warned that the Royal Gwent isn't great with pumps, but apparently the Heath hospital in Cardiff have an amazing pump clinic, if that's any help. Best thing to do is just explain to your clinic what you have told us here, that you are struggling with your levels and your current insulin regime isn't getting you the figures you want, even though you are obviously trying hard to fix it, and that you've heard a pump will give you greater control. Hopefully they will listen! 🙂
 
Hi Breeze - you have just described me to a T! Dx aged 8, had it for 23 years now. Like you, my readings, no matter how hard I tried, never got under control - my A1cs were around the 8-9 mark too.

I was persuaded to go on a pump in 2009 and within THREE months I was down to 7.6, then 7.2 another 3 months after that. I cannot recommend pumps strongly enough to people that, like me, worked so hard but can't seem to get control.

Not sure about funding for S Wales, sorry - but ask at your next D check up. Also, check out RunSweet - there's a section on pumping there and that's where I read up on pumps before I got fitted.
 
While nowhere near as precise as dual waves etc with pumps, people on basal bolus insulin / MDI can split short acting insulin doses for things like pizza and pasta with creamy sauces - but perhaps you haven't yet found the optium split ratios / times.

As Redkite has already said, some "difficult" meals are slightly easier to deal with nearer midday, rather than evenings. And earlier in evening might be easier than 8pm - I'm starving if I haven't eaten by 8pm - nothing to do with diabetes, just that I prefer to eat my tea earlier.
 
Hi on MDI I would have serious spikes at 3am due to delayed food digestion because of having gastroparesis. I went on the pump in November and using the multiwave at night has been amazing. I managed to reduce my HBA1C from 7.8 to 6.8 for the first time ever and the pump is amazing. Prior to that I had been on insulin injections for nearly 42 years.
 
Thank you all so much for your replys. It sounds like a pump could be a great option then.

We are based in cardiff and have been working with the heath hospital dieticians. I have just arranged an appointment with them on july 1st so hopefully they will be able to help out again or put me on the pump waiting list - which she said was ever increasing!

Back to writting down every carb, weight, unit of insulin, activity, etc for a few weeks then! 🙂

Thank you all again for your replys. It really has helped to prove a pump could be worth it.
 
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