Thoughts on Pumping Insulin

Below are some descriptions of my pumping days, primarily early on, but also later on. I have had infusion set problems and sometimes worse control on the pump than shots, but I do not believe I should hide the bad from the good. The pump is the best technology available for treating diabetes, however it takes time to get things working ok. If you have any questions, feel free to email me. I do love the freedom to sleep in, to skip meals, to eat sweets, etc, etc that the pump HAS given me. The largest part of this page summarizes my first 9 months on the pump or so. For anyone who just wants to read the nitty gritty, here it is (after 15 months of pumping:)

Wow! Last week I got back my lowest a1c in 11 years!! 5.9% (with normal avg. being 4.9-6.9)! I don't have a single teenage friend who's gotten under 6.8 (I'm 17 now!). I just received my NEW pumps yesterday--a beautiful clear AND a blue H-Tron Plus. My MM was only 15 months old (well that last one I used was only a month old..after 3 broke they finally sent me something new that wasn't refurbished, but it became too little too late after the numerous probs I had with the company). Already, the Disetronic primes totally by itself, the basal changes are in my opinion smarter because the change is proportional to your NORMAL basal even if there's a basal change in the affected period. Most importantly, this pump is rock solid, and I mean really really solid...no more loose doors or dirt having the chance to get into the lead screw area. I ran a test..my MM 507C took about 40 seconds to bolus one unit of insulin (I believe 35 secs. or so is what MM says), the new H Tron Plus (well I tested the loaner and mine when it came)--5 seconds!! What a difference! Now I get my insulin right away rather than it still clicking after my first bite! Best of all,I have 2 pumps now, so no more having to wait 24+ hours for a replacement refurbished pump. Now, I have had some really bad experiences with MiniMed, so yes, I am biased, but there are tens of thousands out there who have never had a problem with MiniMed. My suggestion to anyone (including my future patients) is do a trial on all 3 pumps before choosing (unless there's an obvious swaying factor like needing a waterproof pump). Animas is the new comer but also has the 3 minute basal system like the disetronic. Any pump is a good choice, you have to discover what's right for YOU. For me, I preferred MiniMed until I had numerous pumps break and problems with customer service. However, had that not repeatedly happened, I'd probably still be on a MiniMed, at least till my normal 4 yr warranty was up.


--NOW PUMPING LIVE!!!--
I started my pump 5 days ago, it's definitely been a rollercoaster, but it's nice not having to do that 10 pm shot! My bg so far have been ok, and my doses are less, but my pump has stayed off about half the night, but there's another long story!! I've had a few "situations" with the pump and needed help and MiniMed's service line is great, even for the silly technical stuff!!


Saturday, July 10...Pumping for 13 days...This was a rough week, my bg were not as stable as they had been the first week, and this was causing me and my parents some frustration. We are working really hard, still checking blood sugars between 10 and 15 times a day. But, as someone once told me, you know with diabetes, the only consistent thing is its inconsistency! I'm sure that there are many factors causing the not so perfect bg, but I am staying in reasonably good control, compared to before. I am lucky, have not forgotten a bolus at all yet. But I did have many infusion set problems this week. One Sof-set would not prime, all of the insulin (after over 20 units through the pump (and manually 3 times)) got stuck at the QR, after calling MM and deciding we couldn't do much, I used a new set..this time, a Silhouette. Then 2 days into it the site with the Silhouette stopped absorbing, so I had to change again. This time I used a Sof-set (thursday), which was working great, until 11pm on Friday I found that my site was bleeding. I'm not too sure why, possibly something bumped it causing it to hit a blood vessel. But these changes definitely affected my bg, they were stressful and I was off the pump for at least 45 minutes because of technical problems...i couldn't leave in a bloody infusion set, so i had to wait to fill a new reservoir and all the priming, etc. Today I've had good bg, but had pizza for lunch and went high..Next time I will try the Dual Wave Bolus. and then I went to 41 b/c I was watching the World Cup, dinner was 30 minutes late. But as you most likely know, with the pump you are meant to have the flexibility to eat when it's convenient for YOU, so that tells me I need to adjust my early evening basal, which I will do tomorrow. The pump is starting to get much better, and I will add a new page just on my experience once I find a good picture and time.


Saturday, July 17...pumping 20 days!! I love my pump, one of the best decisions I made. My bg are not perfect, but they are much easier to manage. I still have some highs and lows, but not to the same extent they were before. Nothing but a cure will give you perfect control, but the pump is definitely 110% better than shots. Basically, it's a learning process. I have some highs for foods that I under bolused for, or rather, foods like pizza and ice cream, which I'm learning need to be bolused for using the Square or Dual Wave boluses. And I've had a few lows recently, b/c I haven't found my "trick" quite yet for exercise..how much to decrease my basal or whether or not to just turn the pump off, but I'm sure I will have it in a few more days. It's a trial and error process, but still much better than shots. You feel like you have much more control of your diabetes, and I love when I can look at a graph of my bg readings and see almost a straight line for a part of the day, on shots, that almost never happened! I love pumping!


Sunday, August 1...pumping over a month!...I love pumping, went to camp and control was so much easier to keep than it would have been on shots. I was using sof-sets at camp, but now am back to my silhouettes which I prefer so much more, and find so much more comfortable. I am trying new sites and they're working rather well (now, that makes my stomach, legs, and behind that I can use). Camp was great, I made some terrific friends, and it was good to meet other people my age with diabetes.

Wednesday, August 25...proud to pump!!...Hmm, what should I say?? My body is still adjusting to pumping, and I am still tweaking my basals. I think part of the reason everything keeps changing so much is because I am a teen and my hormones run wild, and combine that with being new to the pump, it just takes time. This past month, I've heard an alarm a week, everything from the Watchdog Alarm and the lo battery alarm, to the No Delivery alarm..very frustrating, but you learn through experience and supposedly you have the most problems in the first sixth months (while you're learning). I'm enjoying the freedom to snack when I want, and to sleep into 11am and wake up with a good bg! This morning I was 136, exercised and set a temporary basal, and an hour later I was still 136..that's the power of the pump! I have basically been using the Silhouette infusion sets, and am still using both long and short sets. When I had an alarm the other day, 10pm at night, and didn't know what to do, called MiniMed and once again, they were GREAT. My control is so much better, still have swings, but nothing compared to the 20-500 in a day like on shots. Now if I even swing this much, it'd be 50-200. Today I had a high and had to take a shot, not quite sure of the cause, but it is easy enough to correct. Pumping takes patience, as does everything, and extra work at first, but it is definitely worth it! I don't really know what else to say, but if you have any questions feel free to email me.
Nov. 5, 1999--Hmmm, since Sept 24 things have been rough, my #s unbelieveable, they were better on shots compared to this. I had an infection and since then things aren't working right. Not sure what I'm doing or what the next step is, I am definitely frustrated and sort of hate myself saying this, but as of now I feel like doctors are no help and can be such idiots at times. I want to be a peds endo when I grow up and have learned so much already of what NOT to do...

January 22, 2000--I figured I should update this, as I have gotten several emails from people wondering if I'm ok. I'm fine, I did end up in hospital b/c of bg probs earlier this month, highs that the pump AND shots wouldn't bring down, and I think everyone summed that up to hormones, since in hospital they weren't too successful at lowering my bg either. (they and I both used the pump and shots..Humalog and Regular). I need to correct my statement about docs can be idiots...yes, some can, including ones in the hospital who do not know about type 1 diabetes and the pump..but that's only because we have no specialist locally, if we did, I'm sure he or she would've known what he was doing. My endo is not an idiot, and I think that he really cares. I still believe that my best doctor would be a woman who has diabetes and a pump herself, but for now I am happy with my endo. My bg now, I'd say for the past few days, are on the whole great compared to shots. I've been fighting a lot of lows, but on the whole I'm staying under 130. I just wish my body would find the medium, it seems I'm either low all day or high all day, I guess that will come with time. I am now using the 6mm rapids (infusion set by Disetronic, with a 6mm needle which goes in straight, and as of now, the rapids which disconnect are not available for sale in the US. I will be happy when they are, but for now I use MiniMed's sport case, which really isn't that annoying to use everytime I shower.

June 2000---Well, well, I've been pumping almost a year. I realize that my own experiences may seem discouraging and even pessimistic, and at times it is discouraging, but on the whole the pump rocks! I've already mentioned all the newfound freedom I have, and the peak of that is I'm going to Gov. School this summer, a WHOLE MONTH away from home, and my parents aren't that worried about the nights....but I know if I were still on shots, I would never have been allowed to go. I've been using the 6mm Rapid Infusion sets, but am considering returning to micros for the summer so that I can disconnect. This week/last week I had another bottle of "bad humalog" and was running high with ketones, but once I realized it wasn't the set or stress, etc, etc, I figured it out ok. The pump is only a tool, but as of now, the best tool available to us. Oh, and the news of islets---personally I'm encouraged, as I heard one of the NIH researchers speak about islet cells OVER a year ago. I know that they always say a cure is just around the corner, but it is encouraging that they have been talking about islet transplantation for a while.

Sept. 28, 2000- Switched to Disetronic, better product..more reliable, higher quality, no customer service problems. Some of you will disagree with this judgment and my experiences, I know I did, but if you ever walk in my shoes you'll understand. 4 pumps in 1 year rather than 1 pump in 4 years...customer service lacking quality service... constant alarms for no reasons, an uneven screw turn, to be told it was ok unless you had an alarm..then to wind up in hospital before they're replace the pump, which then 18 hrs later after being taken off gives an alarm... as everyone says he doesn't know why he waited so long to start pumping, well I don't know why I put up with MiniMed's crap for so long. i love this new pump and have no doubts about it being a quality product, after (now it's Nov. 4) a month on this pump. No learning curve b/c that was done with my first pump b/c now I understand basals/boluses, but this pump really is sturdier, much faster in insulin delivery, and a better choice for me. Everyone has a different preference, no one should chide anyone on that, but remember don't criticize others for expressing their opinions and experiences. The pump is a challenge, as is everything with diabetes. There never seems to be a consistent day, but with the pump, there is more consistency when compared to shots. I love the freedom I have now to skip breakfast, to work till 11pm and eat dinner whenever I may get my break. At school, when the schedule is changed and I have to eat lunch 90 minutes later than usual, I can deal with it much easier pumping because I don't have Lente peaking. On the whole, I really like my pump, however, that is hard to remember at times, because I've had so many frustrations with it, and I've encountered a lot of problems I never encountered with shots. I'm glad I finally have an infusion set that is comfortable, even though it leaves a needle in me. It's hard finding some where to insert it because I'm thin, but that's nothing too huge to fret over. The pump is not a cure, and it comes with its own set of frustrations, but it is the best tool available. I look forward to the day that MiniMed has integrated the pump and Continuous Glucose Monitoring System, so that I can stop having to test my own blood sugar so much, that to me seems to be the direction a cure may point in (the combination of the pump and sensor with the sensor telling the pump what to do)


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