What are the pros and cons?

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HOBIE said:
So you can stop the insulin you gave yourself the night before on MDI. ?
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No, any more than I can stop the insulin I gave myself via my pump 2 hours ago when I decide I am (or am not) going out for a walk now because it has stopped/started raining/hailing/snowing. But I can eat with or without bolus on both systems to make up for the insulin that is already in my system. Its amazing Hobie, you should try it...
 
Annette Anderson said:
No, any more than I can stop the insulin I gave myself via my pump 2 hours ago when I decide I am (or am not) going out for a walk now because it has stopped/started raining/hailing/snowing. But I can eat with or without bolus on both systems to make up for the insulin that is already in my system. Its amazing Hobie, you should try it...
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I always give my insulin in % & time delays. It is one of the great things about Medtronic. If you have Pasta or similar you can give insulin 50% straight away Then 50 % 45mins later. (or not at all if you cancel it. More in control & NOT like MDI. You try it 🙂
 
Do you know, Hobie, so does my Combo, and I always use it. But I think we were talking about basal insulin here...
 
Annette Anderson said:
Do you know, Hobie, so does my Combo, and I always use it. But I think we were talking about basal insulin here...
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Good so you know the difference between MDI & a how adaptable a pump is Annette 🙂. If you are out for a meal & you don't like it or what ever. You can stop at leased a good % of the insulin going in MDI you cant ?
 
Well only if it was an extended or multiwave bolus, and I certainly don't want or need to do that for every foodstuff available that I may wish to consume.

Nobody is arguing that pumps aren't better Hobie - only that if they hadn't made them available on the NHS - we'd all still be here and enjoying life as much as we ever did when they weren't ! You can't deny that you haven't had a life where you've done all sorts of things - like the kayaking and Lord knows what. About the only things we were banned from was professional diving (and presumably oilrig work since you have to be able to dive and survive a helicopter crash into the sea) and being a commercial airline pilot - and I should imagine - being an astronaut. Dunno about the latter, not something your average school Careers Officer broached ......

Most people never wanted or needed to do those things anyway!
 
HOBIE said:
Good so you know the difference between MDI & a how adaptable a pump is Annette 🙂. If you are out for a meal & you don't like it or what ever. You can stop at leased a good % of the insulin going in MDI you cant ?
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Hobie, I don't understand why you have a bee in your bonnet about this :confused: The thread is about pros and cons - everyone has said that pumps are more flexible than MDI. All people are saying is that someone who doesn't have access to a pump shouldn't think that things like exercise aren't possible on MDI, just that your approach needs to be different. As for not being able to 'stop' insulin if circumstances change, how often does it actually happen in practice that you would need to do it? If things change then you might have to chug some lucozade or eat a couple of jelly babies, not really a showstopper. Pumps provide different solutions and more options, but life can go on without them, and it's important, particularly for newly-diagnosed people who may not have access to them, to know this 🙂

Personally, the prospect of a failed cannula or pump failure would outweigh the possibility to stop insulin half way through a meal, they seem to be a lot more common and leave you with no insulin at all - at least on MDI you generally have your basal insulin still.
 
To me A pump is fantastic bit of kit. It was others who where getting on there high horse 🙂. I f I were out for a meal & I did not like it etc I would not keep eating it. From the age of 3 I have HAD to. Think about that 🙂 High Horse 🙂
 
Presumably you were using bimodal insulin, rather than the more flexible basal bolus regime when you were a child, Hobie? Eating out with basal bolus / MDI can be very flexible - if you are fussy with food and think you might not eat all, you can wait until it arrives, look & taste, then inject. Not a bad plan anyway, in case food is delayed or you're not sure about portion size. It's not as if you eat out every day. For most people it's a treat a few times a year at most, or perhaps regular pub meal after Thurs eve orienteering running group, as I did for several years, but now just once or twice a year.
 
HOBIE said:
I AM TALKING about 10mins before. YOU CAN NOT DO THAT ON MDI TW ! What happens if its a windy day or bad weather ?
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I hate to tell you this Hobie but doing adjustments 10mins before exercise would be a complete and utter waste of time as it takes between 1 and 2 hours before a basal change takes effect. 😛

As everyone says though pumping is great and the gold standard for diabetes treatment with the added comment that the pump is only as good as the user, it only does what you tell it.
 
I think Northerner made a really valid point - lots of people (me included, although my DSN seems to think she can get round it) don't qualify for a pump, or wouldn't be able / willing to put in the work it requires at the beginning to change systems. I would probably stick at MDI if my levels hadn't gone haywire after surgery and being a lady of a certain age. It's not even that I necessarily think it will be the answer to all of my problems, more that I could actually do with having something positive by way of diabetes management to focus on. It is perfectly reasonable for people to not want one, or not, hence the thread question! To keep with the equine theme - surely it's horses for courses! 🙂
 
Agree Steph it is - different steeds for different needs. :D The vast majority of T1's in this country use MDI (or an injected insulin regimen of some sort) and manage perfectly well, myself included (some of the time anyway 😉). I think what's telling though is that those who have gone onto pumps (some with many years of diabetic experience) have almost without exception stated they prefer it and are achieving better control. I realise you need to put the work in to get the best out of it (the same is true of MDI - more effort in equals better results) but I think it's the closest thing in operation T1's have to a working pancreas.
 
When I went to my pump interest session (which my husband for some reason finds hilarious), I asked the DSN there how many people on her experience had tried the pump and gone back to injections. She said she could count them on one hand (she has been running pump clinics for 12 years). I asked why they didn't like it and she said some were allergic to the stuff you stick the cannula on with, but the others had unrealistic expectations of the pump and weren't prepared tp put the work in. Like you say, Matt Cycle, as on here, the vast majority of people once on the pump would never go back.
 
Copepod said:
Presumably you were using bimodal insulin, rather than the more flexible basal bolus regime when you were a child, Hobie? Eating out with basal bolus / MDI can be very flexible - if you are fussy with food and think you might not eat all, you can wait until it arrives, look & taste, then inject. Not a bad plan anyway, in case food is delayed or you're not sure about portion size. It's not as if you eat out every day. For most people it's a treat a few times a year at most, or perhaps regular pub meal after Thurs eve orienteering running group, as I did for several years, but now just once or twice a year.
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All types of Insulin Copepod & am using the SAME in my pump as I was using on many years of MDI.
 
A very specific question, Hobie - what type of insulin regime were you using as a child when you said it was difficult if you didn't like the food that arrived when you were eating out? I'm guessing bimodal insulin, rather than basal bolus / MDI regime? I'm also pretty sure that you only use short acting insulin, not the bimodal nor long acting that you have used in the past, in your pump, to serve as both basal and bolus? Which is OK until pump fails in driving rain on a 2 day mountain marathin which is what happened to my friend, so she had to use the back up pens / syringes she was carrying. Personally, I wouldn't want to carry that extra weight as well as a pump and spares, hwne every gram counts. I'm happy that your pum suits you, but feel it's unfair to give people new to type 1 diabetes the impression that an adventurous, spontaneous and exciting life is possible only with a pump.
 
I have been on the lot Copeod. 1 injection a day / 2 & 4/5. As I have said in the past I used to spend hours out in the North Sea, Catamaran. Jet Ski & Windy Board. Personally I would NOT want go back to injections. You stick to what you know. 🙂
 
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