Should I get the pump (Type1 Diabetic)

[Reece Sargent]

Had type 1 diabetes for over 4 years now and have come across these pumps, are they worth it etc ? And do they hurt?

 

[helli]

My pump has been fantastic for me and does not hurt.

But, in the UK it is not just something you can decide you want. They are expensive so not available to every one.
If you are interested, I recommend reading more about their pros and cons, build a case why the NHS should invest in you (what are you struggling with on MDI?) and talk to your diabetes team.
Expect to have to undertake training if you haven't done something like DAFNE already and show you have the time to invest in getting the most out of a pump.

Like many things, every CCG is different - they interpret the criteria differently and offer different pumps. So, on this second point, until you have spoken to your team don't waste time selecting your preferred pump - you may be disappointed that it is not an option available to you.

 

[everydayupsanddowns]

It’s a very personal decision I think, though it’s interesting that so few people on insulin pumps switch back.

I was quite ‘pump averse’ for a number of years, and was unsure if it would work for me, but more than 8 years on and I would really not want to go back to injections.

I had a couple of days back on injections when I switched between pumps, and was reminded how relatively inflexible injections are for me, and how much I value the precision, flexibility and adjustability of a pump.

It’s not that pumps are ‘plug and play’... they do need quite a bit of work to get the best out of them, especially in the beginning. But they suit me and I am glad I made the switch.

I wrote this after approx 6 months of pump use, if it helps

Face-off: MDI vs Pump

Because no two days with type 1 diabetes are the same. Except when they are. The ups and downs of life with T1D.

www.everydayupsanddowns.co.uk

 

[Inka]

Had type 1 diabetes for over 4 years now and have come across these pumps, are they worth it etc ? And do they hurt?

They don’t hurt but you have to insert the cannulas every 3 days so that ‘hurts’ just like an injection ‘hurts’ - ie it’s not painless.

Pumps are just another insulin delivery system. They don’t control your diabetes. You still have to put the work in. For me, the major benefit is the ability to fine tune my basal hour by hour.

You need to fulfil certain criteria to get a pump, so you would first have to see if you’d qualify for one.

 

[SB2015]

I was on injections for about 5 years. I found it very difficult to manage without hypos overnight, and found that I wanted more flexibility to adjust things throughout the day.

The insertion of a cannula is no more painful than an injection, but the difference is that it is one every 2 or three days rather than 4/5 time every day. Once it is in it doesn’t hurt, except on the odd occasions when I hit a nerve, and that is no different to injections.

For me the pump has enabled me to adapt my basal insulin hour by hour to suit what I need. I also liked being able to turn my pump up or down according to what I am doing without needing to plan in the morning. It does take some work, especially at the start, and you need to keep adjusting things, but it was a lot easier for me.

Having said that I know others who are just as happy using injections and have added in the Libre to help them makes changes to timing their injections, their diet and activity. Different things suit different people. I certainly would not want to go back to injections.

 

[mark king]

Pumps are great and overall they are painless in use. Yes you have to change the pod every 3 days and when you attach the canular each time there is some slight canular point sensation but only for a very short time. It's definitely nothing to make me want to not use it.
Don't forget you have to inject every meal time while with the pump you only insert the cannular once then it works over 3 days.
As others have said the fact that you can fine tune your dosage hourly and then have that set for every day of use is a big plus when compared to injecting through a needle multiple time daily.

If you qualify in your area for free NHS pump issue go for it, mines an OmniPod dash..

 

[MrDaibetes]

I find Diabetes technology has helped me manage my diabetes to the best I can. I understand technology isn't for everyone and again it depends if you have been offered an insulin pump or you going to put up a case.

There are nice guidelines that should help you build up a case as to why you should have an Insulin pump.

Insulin pumps neet a site change every 2/3 days this means inserting a cannula into the skin, sometimes this is painless but the majority of the time it is a short lasted pain, and it outways the pros for me.

The only thing I can suggest is to research insulin pumps and then speak to your diabetes team about it.

Good luck and let us know what you decide.

 

[trophywench]

Hoping to clarify, the nice guidelines are really "NICE Guidelines" (National Institute for Clinical Excellence) should you wish to look em up. ie instructions on what SHOULD happen under the care of a doctor in the UK in the NHS.

 

[KS76]

Pumps are great and overall they are painless in use. Yes you have to change the pod every 3 days and when you attach the canular each time there is some slight canular point sensation but only for a very short time. It's definitely nothing to make me want to not use it.
Don't forget you have to inject every meal time while with the pump you only insert the cannular once then it works over 3 days.
As others have said the fact that you can fine tune your dosage hourly and then have that set for every day of use is a big plus when compared to injecting through a needle multiple time daily.

If you qualify in your area for free NHS pump issue go for it, mines an OmniPod dash..

Hi I read that your on the Omnipod dash and I wanted to ask if you can go longer than 3 days to change the cannula? If you fill it with more insulin can you go an extra day perhaps? I have never used a pump so know nothing about them. I am on a waiting list for one and the Omnipod is one that I can go for. Also do you find it quite bulky on your arm? I use the Libre 2 and that doesn't bother me at all but the pump looks a lot bigger.
If your out and about can you change the cannula/pump quite easily? I have visions of me being at work or something and realise I need to change it and it wouldn't be convenient.
Sorry for all the questions, hope you can help.

 

[Inka]

@KS76 All pumps need the cannula changing every three days (or sometimes every two days for steel cannulas). It’s not to do with the amount of insulin left, it’s to rotate the pump sites, reduce the risk of lumps, and reduce the risk of infections/irritation.

 

[mark king]

Hello KS76
You asked above? "Hi I read that your on the Omnipod dash and I wanted to ask if you can go longer than 3 days to change the cannula? If you fill it with more insulin can you go an extra day perhaps?"
The quick answer is no.
My pod and I assume others monitor the amount of insulin they contain through their use. They alarm when the user settable remaining level is reached, or when the 3 days are up, which ever occurs first.
At that point it tells you to change your pod which you can't ignore because the alarm keeps beep beeping.
My choice is have the 3 day period set for 8am and it gives you a little beep 1 hour before change due then the nearer to the time it gets a little more frantic with the beeping.
Both the pod and the reader beep with warnings.
So the warnings are primarily set for a fixed 3-day period [not alterable] with the back up if the insulin reaches the user set low level warning.
Additionally there is a battery [non replaceable] inside the pod so that may also be a limiting time factor.

I must admit I too would like my pod to run for longer say 7 days minimum, I'll keep my fingers crossed.

Best
EDIT more answers:>>>
* Pod not bulky, I tend to use my thighs mainly.
* It's about 2 x Libre 2 in size.
* It is quite quick to change, but there is some set up to do.
* When to change -- that's why I set mine expire at 8am morning time, its 3 day expire time is the same every time unless it is because of an out of insulin alarm, which means you will need access to a spare. So set a replace time to allow you to get to work. You control it not it control you.

 

[KS76]

Hello KS76
You asked above? "Hi I read that your on the Omnipod dash and I wanted to ask if you can go longer than 3 days to change the cannula? If you fill it with more insulin can you go an extra day perhaps?"
The quick answer is no.
My pod and I assume others monitor the amount of insulin they contain through their use. They alarm when the user settable remaining level is reached, or when the 3 days are up, which ever occurs first.
At that point it tells you to change your pod which you can't ignore because the alarm keeps beep beeping.
My choice is have the 3 day period set for 8am and it gives you a little beep 1 hour before change due then the nearer to the time it gets a little more frantic with the beeping.
Both the pod and the reader beep with warnings.
So the warnings are primarily set for a fixed 3-day period [not alterable] with the back up if the insulin reaches the user set low level warning.
Additionally there is a battery [non replaceable] inside the pod so that may also be a limiting time factor.

I must admit I too would like my pod to run for longer say 7 days minimum, I'll keep my fingers crossed.

Best

Thanks for your reply, I understand about the 3 day limit...7 days would be great though!!
Do you get use to the bulk of it on your arm especially when sleeping?
Do you time the change of the cannula to when you know you are going to be home so its easier?

 

[mark king]

Hello KS76.
I use my thighs mostly now just swapping legs and position thereon alternately.
No problems at all when sleeping but some times when on say a hard floor you can feel it but not painful, a bit like laying on your phone.
Yes best time for me is morning but I am retired. If I was still at work I would set it so I had time to do it before I left for work. Once you're used to doing the change it will take about 3 - 5mins to do. Don't forget the change pod alarm will give a warning to change 1 hour prior to the change time. That could be a bit of an issue in that you may want to sleep in.

Attaching the pod is simple you fill it, peel off the self adhesive paper and stick where you want it.
Then you hit the start button on your reader and it pings the canular in -- all done that's it.

Best

 

[KS76]

Hello KS76.
I use my thighs mostly now just swapping legs and position thereon alternately.
No problems at all when sleeping but some times when on say a hard floor you can feel it but not painful, a bit like laying on your phone.
Yes best time for me is morning but I am retired. If I was still at work I would set it so I had time to do it before I left for work. Once you're used to doing the change it will take about 3 - 5mins to do. Don't forget the change pod alarm will give a warning to change 1 hour prior to the change time. That could be a bit of an issue in that you may want to sleep in.

Attaching the pod is simple you fill it, peel off the self adhesive paper and stick where you want it.
Then you hit the start button on your reader and it pings the canular in -- all done that's it.

Best

I think it all sounds straight forward and once you get use to it then its like anything it becomes quicker and easier.
Planning a time would be something to think about but I'm sure I can plan it when it comes to it.
I'm still on a waiting list to get the pump and with covid its just taking longer, I keep bugging the DSN to get it and luckily she is doing what she can to move it along quicker.

Thanks again for answering my questions.

 

[helli]

I have a different patch pump which needs to be changed every 3 days but I have an 8 hour buffer. So, if I did get to work and realise I had forgotten I don't need to panic. I could change it at lunch time or leave a little early.
I tend to use this buffer at weekends - I usually change my pump after my shower. My shower might be a tad later on a weekend.
On a few occasions, I have got 3 pumps to last 10 days buy utilsing this buffer.

I thought OmniPod has this buffer too - you don't have to change it exactly 72 hours after the last change.

That said, there is no accounting for pumps' timings when they decide to fail. This is rare but at a cafe with the in-laws was awkward as was at a theme park whilst queuing for a ride.
(I say "queuing" but pumps can allow some queue jumping at theme parks ... just not for roller coasters where the strong magnets could affect the pump.)

 

[KS76]

I have a different patch pump which needs to be changed every 3 days but I have an 8 hour buffer. So, if I did get to work and realise I had forgotten I don't need to panic. I could change it at lunch time or leave a little early.
I tend to use this buffer at weekends - I usually change my pump after my shower. My shower might be a tad later on a weekend.
On a few occasions, I have got 3 pumps to last 10 days buy utilsing this buffer.

I thought OmniPod has this buffer too - you don't have to change it exactly 72 hours after the last change.

That said, there is no accounting for pumps' timings when they decide to fail. This is rare but at a cafe with the in-laws was awkward as was at a theme park whilst queuing for a ride.
(I say "queuing" but pumps can allow some queue jumping at theme parks ... just not for roller coasters where the strong magnets could affect the pump.)

Which pump are you on? Is yours wireless like Omnipod. What is a buffer? How can you get it to last longer than 3 days?
Sorry for asking all these questions but I really don't know all these terms related to pumps.

 

[helli]

Which pump are you on? Is yours wireless like Omnipod. What is a buffer? How can you get it to last longer than 3 days?
Sorry for asking all these questions but I really don't know all these terms related to pumps.

I use a Medtrum A6 pump. I am not sure what you mean by "wireless" - it has no tube and is controlled with my phone via Bluetooth so no wires attached.
It is not a very common pump. As has been said previously, there is little point researching and deciding which pump you want until you know what is available in your area.
By "buffer" I mean I have to do a set change within 3 days and 8 hours of the last one rather than exactly 3 days ... assuming I have enough insulin in my pump.
There is nothing I "need" to do to get these extra 8 hours - the pump is designed that way and I thought OmniPod was too.

I used to have a tubey pump (an Animas Vibe which is no longer available). There was no electronics that stopped it working if I changed it less often than every 3 days unless I ran out of insulin. As I have sensitive skin, the cannula would become itchy when I kept it on for 4 days.
I have read somewhere that one of the reasons for the cadence of set changes is that there is a reaction between the insulin and the plastic of the cartridges. At least this is the reason that was given for not pre-filling my Animas cartridges.

To be honest, I would not get hung up on the frequency of set changes. It is a small thing to do. Most pumps can warn you when it is needed so you don't forget and it takes less time overall than the aggregation of all needle changes, test shots and pen changes you need to do on MDI.

 

[KS76]

I use a Medtrum A6 pump. I am not sure what you mean by "wireless" - it has no tube and is controlled with my phone via Bluetooth so no wires attached.
It is not a very common pump. As has been said previously, there is little point researching and deciding which pump you want until you know what is available in your area.
By "buffer" I mean I have to do a set change within 3 days and 8 hours of the last one rather than exactly 3 days ... assuming I have enough insulin in my pump.
There is nothing I "need" to do to get these extra 8 hours - the pump is designed that way and I thought OmniPod was too.

I used to have a tubey pump (an Animas Vibe which is no longer available). There was no electronics that stopped it working if I changed it less often than every 3 days unless I ran out of insulin. As I have sensitive skin, the cannula would become itchy when I kept it on for 4 days.
I have read somewhere that one of the reasons for the cadence of set changes is that there is a reaction between the insulin and the plastic of the cartridges. At least this is the reason that was given for not pre-filling my Animas cartridges.

To be honest, I would not get hung up on the frequency of set changes. It is a small thing to do. Most pumps can warn you when it is needed so you don't forget and it takes less time overall than the aggregation of all needle changes, test shots and pen changes you need to do on MDI.

Thanks for your information, was helpful!

 

[mark king]

Hello Helli.
I don't know if I can extend the Dash pump but it does come with a manual that is printed out like a bible, there's loadsa info but once I had my training and new how to set it up I haven't gone any further. The pump pumps in a background of insulin at varying determined amounts hourly. My pump is set to do this for every hour 24/7 but I can suspend it if I need to, say for instance I am going Hyper, this would stop the insulin pumping but not the clock.
You additionally calculate from your meal the carbs and add that into the pump which pumps out the required amount of extra insulin.
I can stop the pump all together even remove it and not add a new pump until I'm ready to but of course there will be no background insulin being added to my system hourly. This would mean I would lose control of my BG and I would start to head for a Hyper.

I will go and check if I can extend the working time for the Dash as it will be good to confirm.

Best

 

[helli]

@mark king I am not talking about extending the like of a pod. It has nothing to do with suspending the basal or stopping any dosing.
It is just that the Medtrum patch (equivalent to the pod) actually lasts 8 hours longer than the "official" 3 days. 72 days after starting anew patch, I could get my phone to alert that the patch is about to expire but I know that it really expires 8 hours later. The reason for this is that it is not convenient to change at precisely the same time of day each time.
I am not sure it is mentioned in the guide. It was just a question I asked when I had my initial training.
I find the local Medtrum team very helpful. If you have a similar team for the OmniPod I would recommend asking.