Pump?

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Wilsonmt12

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Type 1
Hello there.
I've been diabetic for 11 years, I'm now 26. My control has always been pretty good. 2 years ago I started a new, more active job. Ever since my control has gotten worse. My hbac thing was like 7-8% 4 years ago, now it's like 11-12%. (I forgot what it is in the new measurement method). My working day is unpredictable so I often can't predict if I will be doing more active tasks until after I've eaten and injected after breakfast/lunch, so sometimes under estimate my insulin dose so I won't end up running low. I'm currently using around 1:1-2 carb:novorapid ratio after eating and 17u of lantus long acting.
My DN wants me to consider going on a pump. I'm just wondering if people have experience like mine? Does the pump offer more flexibility? And does it really reduce highs(which I'm more susceptible to) and also lows? Any other stories about life on a pump would be greatly appreciated.
Thanks
Matt
 
Hi matt a warm welcome to the forum sorry not on a pump personally,but we have a pumping section on here so have a good look through that to, there's a lovely bunch of helpful members on a pump to who will be very helpful... Enjoy the board! 🙂
 
Hi Matt, welcome to the forum 🙂 I don't have a pump myself, but I think you will find that the majority of our members that do would say that it is the best and most flexible way they have to help control their diabetes, and I would also think it would offer you the greatest flexibility with your unpredictable working patterns. Have a browse of the Pumping section and you will find many posts like yours wondering just how good they are, plus people's responses.

I would also suggest having a look at the INPUT website for more information:

http://www.input.me.uk/
 
I moved your original thread Matt - I'll delete your new one so it doesn't become confusing trying to reply to two! 🙂
 
Yes I think a pump would offer greater control with highs and lows. With the pump if you are more.active.you can put a reduced temporary basal rate at a few touches of a burton. Also highs as you can bolus.small amounts if needed to correct slightly. New on a pump and am aware getting the basal pattern correct is alot of hard work to start but am sure out will be well worth it. Only had a pimp today and already wouldn't go back on mdi.
 
Hi Matt. I've had my pump for just over a year now and one of the biggest benefits has been in smoothing out the swings from highs to lows (as well as a significant improvement in my HbA1C). As you'll see from other comments on this forum, it does take a bit of work in getting your basal profile fine tuned but it's worthwhile. I wouldn't go back to MDI.
 
I did a bit of 'compare and contrast' between MDI, MDI with Accu-chek Expert and 'Artoo' my pump after I'd been on the pump for about 6 months.

Full write up is here: http://www.everydayupsanddowns.co.uk/2012/05/face-off-mdi-vs-pump.html

But here's a snippet about results/numbers of highs, lows etc.

Hypos - below 3.9
Old MDI was the worst with 20% of readings, the Expert reduced this to 10% of readings and Artoo has made a small improvement taking this down to 8.7% - clearly Artoo and I still have work to do here.

Hypos - below 3
The old MDI records really don't do well here, with almost half of all hypos coming in below the 3 mark. Compared to what I'm used to in recent years it made uncomfortable viewing. Both the Expert and Artoo fare much better with 2.4% and 2% of all readings coming in at that level. Both with the Expert and with Artoo, none of these hypos have been 'nasties'. I can't remember the last time I had a really bad one it was so many years ago. I've been functioning, spotted them and able to treat them all myself. That may not have been the case with the old MDI records.

Highs - above 10
The same pattern of worse, slightly better, better again repeats here. Old MDI shows 19% of readings over 10, with the Expert that falls to 16% and reduces to 13% with Artoos assistance.

Highs - above 13 (234)
This is where Artoo really shines at the moment. Despite having subjected me to an occasional stratospheric BG with a dodgy set, in the 60 days of data Artoo only allowed 0.04% of readings to stray over 13. The Expert does surprisingly badly here with 6% while even old chaotic-style MDI scrapes in with 5%.

Averages and SD
While averages can hide a multitude of unpleasant detail, I think that here they do seem to suggest positive progression. The old MDI average was 6.8 with an SD of 3.3, the Expert improves this with a slightly higher average 7.2 but reduced SD of 3.0. Artoo though trumps them all with the joint lowest average 6.8 and a significantly lower SD of 2.4
Click to expand...
 
Wilsonmt12 said:
Hello there.
I've been diabetic for 11 years, I'm now 26. My control has always been pretty good. 2 years ago I started a new, more active job. Ever since my control has gotten worse. My hbac thing was like 7-8% 4 years ago, now it's like 11-12%. (I forgot what it is in the new measurement method). My working day is unpredictable so I often can't predict if I will be doing more active tasks until after I've eaten and injected after breakfast/lunch, so sometimes under estimate my insulin dose so I won't end up running low. I'm currently using around 1:1-2 carb:novorapid ratio after eating and 17u of lantus long acting.
My DN wants me to consider going on a pump. I'm just wondering if people have experience like mine? Does the pump offer more flexibility? And does it really reduce highs(which I'm more susceptible to) and also lows? Any other stories about life on a pump would be greatly appreciated.
Thanks
Matt
Click to expand...
Hi Matt,

Just posted a long reply and it disappeared!

I would wholeheartedly recommend a pump, as its insulin delivery is the closest approximation to a working pancreas that is currently available. My son (diagnosed 8 years ago) has been on a pump for the last 5 years, and while it's fair to say that it's harder work than MDI if you want to get the best out of the pump features, it has improved his diabetes control and his quality of life enormously.

You mention that you have unpredictable activity levels during the working day - this is actually very similar to my son, as we can never predict from one day to the next whether he will be charging round the school playground after lunch or standing around chatting. With the pump we can afford to be quite aggressive with his meal boluses, thus avoiding post-meal spikes in BG levels, and then set a temporary reduced basal rate for a couple of hours if necessary. Sometimes he also has a free-carb snack (ie unbolused for), depending on his levels and how energetic he is being.

The pump enables us to programme basal rates by the half-hour throughout the day, tailored to his own unique needs, and we can temporarily alter any of these to cope with exercise, illness, etc etc. We also use an increased basal rate for several hours after eating a high-fat meal such as a curry or a Sunday roast - for meals like this we bolus as normal for the carbs, but use an increased basal to deal with the spike in BG levels later on caused by the fat metabolising. On MDI we would have ended up having to give a correction.

We can also programme a different basal pattern for weekends when he tends to be lazier!

Pumps can deliver boluses either all upfront, or split over a number of hours to match the insulin with foods that digest slowly such as pasta.

His Hba1c was always in the 8's on MDI, now on the pump it is between 6.9-7.5. BG levels are still quite variable (to be expected in a growing child), but the highs are less excessive than on MDI (rarely above 14, and never in the 20's unless he forgets a meal bolus). Hypos probably happen at about the same rate as before.

Go for a pump, you won't regret it! 🙂
 
Thanks for the replies everyone. The general concensus seems to be that pumps really help, so I'm gonna start the process of getting on one and hopefully it'll give me greater control.
 
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