I have been on an insulin pump for five years and find it an amazing tool to control my blood sugar.
I think that the key to successful use is testing your blood sugar often - before and after meals and whenever you are having a snack. This keeps spiking to a minimum, but of course you have to be adept at counting carbs.
Interesting article. I agree that the pump is not for everyone. I have had my pump for a year and a half; I was injecting insulin for a year before that. I went onto insulin because my doctor and I decided to stop Avandia after the metadata study and two oral meds alone were not enough to get decent blood sugar numbers. While I was able to achieve the same A1cs with injections as with the pump, I find the pump so much more helpful since I can do extended boluses for fatty foods and do lots of little boluses when I'm at a party, etc. I absolutely hated injecting myself 6 times a day (long-acting at night, 3 meals and two snacks); I have four different basal rates during the day so the pump works well for me. But I test like crazy, and adjust basals, etc. myself rather than calling my endo's office. I will say, having had 6 surgeries in the last 18 months, the pump has really helped me control my blood sugars while recovering from those surgeries.
I hope the result of the FDA study is more education and not more limitations on the availability of pump technology.
Ann, I'm so glad to hear from a person who has been there and back. I have gotten pretty tired of the "pump snobs". When I meet another family taking the diabetic journey, the conversation tends to stop when we are asked if we are pumping, and our answer is no. I'm told what a miracle the device is, when in fact, the complications can be swift and sometimes go unnoticed. I think some parents check out of the process when their teen is pumping. It seems like a very complicated thing to leave up to a young person. Every method of delivering insulin is good, and one size does not fit all. I don't like feeling shamed that we're not using the lastest and greatest. Very interesting points you have made! Thanks, Ann.
I have had type 1 diabetes for 26 years. I had an internal pump implanted through a study at UC Irvine in the 80's. It worked great for a couple years but the surgeries cut some nerves. It felt almost like being normal-just with a remote control.
In the 90's I tried an external pump but did not like it. You had to change sights after 3 days and I did not have enough sights that weren't already sore. I had to get creative about where to put the pump when in a dress, taking a shower, etc. I sewed pockets into t-shirts and pajamas. After almost 2 years, I said, "No more." I have been taking shots for the last 16+ years.
When doctors ask about the pump, I tell them No thanks.
I take humalog and Lantus and together they work just fine. Pumps may have changed but to me, they are more hassle than they are worth!
i love my pump...my levels are better, I have had my Medtronic MiniMed pump for four years...I believe it is the next best thing to having a working pancreas....Everyone I have ever met that uses a pump loves it..I did have thorough training from my diabetes educator. She was very patient and I had multiple visits b4 we did a test run with saline...I would never want to be with-out it!!! Please know there are people that have had success with the insulin pumps and that not everyone has issues!!!!
Thanks, Samantha
babyboop_31@yahoo.com
Ann: I could not agree with you more. As one of the members of that special FDA advisory panel reviewing insulin pump user errors vs. pump mechanical/functional errors, it is obvious that extensive education and training re pump use is essential for successful management of blood sugars. Having said that, not everyone is interested in transitioning to the insulin pump. It is insulin that is required to manage diabetes. The important take-home message is that the person with diabetes in conjunction with the diabetes team should make the decision re method of insulin administration based on their personal desires and needs.
I was diagnosed as diabetic in 1991, and began taking insulin injections soon after that, and then in March of 2005 went on total insulin injections. I’ve been on a pump since the middle of October, 2009, and I like it way more than giving myself injections multiple times daily. Many times there was pain when giving the injections, and blood dripping from the injection site. I frequently wear white trousers and would find blood spots on them after my injections. None of that happens now! Since getting the pump, the only pain I’ve had was when I installed the infusion set a couple inches directly above my navel a few weeks ago, and it hurt some until I went to a new site. My two A1c results since getting the pump have been 6.0, which I want to lower a little bit. I change the infusion sites on Monday, and Friday, as it was a hassle to do it every three days. I also learned that putting the infusion site below my belt line caused delivery problems and I’d have to pull the tubing all the way out to get complete deliveries. My tester sends the result of my blood sugar test to the pump, usually before I can see it on the tester. The pump calculates how much insulin to inject, from my blood sugar level and the number of carbs I’ve calculated that I’m eating, based on the settings I’ve given the pump. It’s just as easy to make mistakes with the pump as it was with injections; however, the pump alerts me when I accidentally order too much insulin, since I see how much is going to be issued--do I really want to take that much? I’m only taking one kind of insulin so can’t accidentally take the wrong kind; and, if I take it too soon after a previous dosage, it will alert me to that problem, so I can decide if I really want the extra insulin. So far the problems I’ve had with the pump have only been of the ID 10T (IDIOT!) variety.
Hi Dan!
Thanks for commenting! Finding the places for the canula does take time! I was really limited on where to insert the canula, abs were out until I found the sure-T(medtronic), which has a metal needle instead of plastic. It opened up many new spots that had previously not worked with a plastic tip! The waist band issue was a problem for me too! I also used the underside of my arms and some on my back (between rib cage and top of the hips) for canula insertion. One time, I hit a vein and it looked like murder had happened in my kitchen! I don't know exactly what I hit but when I pulled the canula out the blood was running down my body from my arm. I thought my husband was never going to peer out of the closet! 
Don't give up, it sounds like it has been a good switch! LOL on ID 10T error! Very cute!
I started on the OmniPod Insulin Pump January 14, 2010. All I can say is, I LOVE IT. My sugars are finally in the normal range. I did have to go through training on how to eat again, and discovered my original training was way off. Now I'm paying far more attention to what I eat and actually testing my blood more often. I'm more in control and have so much more freedom with the OmniPod.
I am also using the Omnipod pump for almost 2 years now & I love it. A lot of people don't know about it. For years my doctor wanted me to get on the pump, but I would not consider using a pump with the tubes & the hassle of sewing pockets into clothes, etc. The Omnipod sticks to your skin & you move it every 3 days. No tubes! I am a Type 1 diabetic for 29 years & was taking 5-7 injections per day & could never get my blood sugars steady. I had 2 seizures while taking injections. Sometimes I could not remember if I took my insulin shot or not. With the pump it keeps track of when my last bolus was & adjusts for any insulin still working in my system when I take another bolus. I can also change my insulin to carb ratios during the day & it is automatically calculated for me. I use four to five different basal settings during the day & night & can also lower them temorarily for extra exercise. My A1C's are improved, less insulin reactions & less highs.
Hi Irene!
Thanks for commenting! And we are in the same club, I've had diabetes 40 years (this easter actually) and doing great too! would love to hear more of your history of living with D. My next post will be about living with it, what it used to look like and where I am now. Stories of living in general always fascinate me!
Thanks again!
I have used a Medtronic insulin pump for 13 years. Without access to this wonderful piece of modern equipment I would have several severe complications. These have been avoided or controlled with the ability to control blood glucose levels. I am a type 2 diabetic with a history of 30 years with this disease. I keep tight control and have a HgbA1c of 6.3. Of course I have a great Endocrinologist Dr. Victor Perkel in Redlands, CA and the services of his great staff. The interest of the physician is of most import. Most doctors don't want to do all the work involved in becoming experts in pump use or in Diabetes overall.
Most doctors don't want to do all the work involved in becoming experts in pump use or in Diabetes overall.
I could not agree more! In fact, I was hoping this post would reflect that I think it is less a pump problem and more user issue! But kudos to the FDA for investigating! So many times, we bristle from their lack of effort, but in this case good for them! Perhaps, this will help shed light on the issue with medicine, rather than technology! I often wonder if healthcare changes need to start with hospitals' patient practices!
Indeed! The 6 minite visit with your doctor must be accomplished and you must be shown the door so s/he can get to the next patient. When a patient is Diabetic the visit can not be accomplished whether he is using a pump, syringes or meds.
My docs do not rush me! That was my understanding when I had my first visit. I demand (yes demand) they listen to any problem that may have arisen since the last visit and instructions on changes etc., that may be needed for great control.
Today one has to stand up for themselves. Can hardly wait to see what Obamacare allows us to have. Perhaps absolutely nothing if you are a Diabetic over 50.
Good luck to us all and God bless us all as Tiny Tim said in the great Christmas story. We will need all the help we can get.
I enjoyed your article on the insulin pump issues. I too have been prescribed the pump. (two years ago) I have yet to have gained enough information on the use of the pump or adequate training onthe use to feel comfortable enough to depend on it and the sensor. I also have Addisons disease, so I am on prednisone and this adds to my high blood sugar issues, so keeping control of my blood sugars is a constant battle. I have talked to other people that have Addisons and diabetes and they have found the pump very helpful. Me, I have issues with the "stacking" of insulin and a possible real problem with a low BS that could put me in a coma.
One other issue to look into, as well, is my insurance, Medicare, will only allow me to test BS 4 times a day. Some people need to test more often! I had to get exception from doctor for the 6-8 times a day I have to test due to the prednisone. This has been a very exasperating experience!
Medicare only allows four tests per day?
That is the guideline for Type 2's not on Insulin.
Request you doctor change your status so that you can have unlimited acces to your meter!
I test some days 12 times when things have gone awry. My HMO provides as many test strips as I request to keep my Bg's inline.
I have since received a deference from Medicare for the extra test strips. The problem seems to be that when you go to the doctor nowadays you don't dare bring up more then one issue at a time. I cant begin to tell you how many times I have tried to bring up other issues at an appointment for whatever, and been told that I have to schedule another appointment to address that issue. Then by the time the appointment comes around, I forget wh I made it in the first place. Or, worse, like recently, I ended up in the hospital for an Addisons crisis and pleurisy, which I had told the doctor about a week earlier when I was having trouble breathing. I just don't get it, but the doctors' make more money that way. Now, not only do I have to pay a deductible of over $1000 for hospital visit, I have to see another specialist and then back to follow up with my regular doctor.
I sincerely appreciate your response. I am definately in great need of additional information and training. The dexcom is a great idea! I will bring it up at my next appointment and let you know what response I get. The bottom line is the people that handle these claims at whatever provider are not trained nor are they really interested in what the individual needs for their proper care. They only follow the memos from superiors to keep costs own, at the eril of all of our health and welfare. We know our bodies and it's responses to treatment, why isn't that good enough for the medical profession as a place to start? I am going to follow up with this information. I am so thankful that I found this site!
My 5 y/o son has autism and is completely freaked out by needles, so the pump was a godsend from the start for us. But needle phobia aside, it's getting to the point where a pump is practically mandatory for children who can't yet give themselves injections. Liability issues in the schools limit the people who can give a child injections to either a nurse or a family member. So, unless you can pop over to the school every time your child needs a shot, you've got a problem. It's a rare school these days that boasts a full time nurse and some don't have a nurse at all, only a health aide. Fortunately everybody is allowed to give a pump bolus, so the child can attend school like every other kid (once you get the pertinent people trained of course).
I have used the insulin pump for about 5 years and I really love the pump and wish I had gone for it a few years before I did. There can be problems with the pump instead of the user. I had a pump that had a malfunction and delivered a whole resovoir of insulin into me at one time. Luckily my husband had to come back into the house for something and he found me while I was still conscious enough to drink something. It took an entire quart of soda containing sugar to bring me back to normal. It also suspended insulin delivery for me during the noght one time. The company sent me an overnight delivery of a replacement pump and it has worked great. I have been diabetic for nearly 41 years now. I have been using the realtime cgm since Dec. of 08 and it is great. My A1C has been 6.0 and 6.1 and has never been in greater control than it is now. When I was first diagnosed the insulin was made from animal and home testing of blood glucose was not available. Then diabetics were only allowed to have pasta and potatoes as a rare treat. Things have come along way since then and pumps in use with cgm's are the greatest things available. I have had many problems since starting on the rdna insulin but all has improved greatly for me since I am no longer on Lantus insulin. When I was using the Lantus I had a severe low during the early morning hours while asleep and went into seizures and had aspiration and nearly choked to death. I take Humalog with my pump and it works great. Hopefully they will be able to come up with a much lighter pump that is less bulky. The main problem I have is trying to get the insurance to approve the pump supplies, I have to have a letter of medical necessity from my Endocrinologist everytime I need supplies. Sorry this is so long. Sincerely, Sharon
What is a dexcom? How is it used? Thank You for any information!
I have a g-daughter diagnosed with type 1 when she was 4 years old. She was scared to death of the needles and the lancet for a long while. Over the years she got used to the routine of checking and injecting. She went on the pump at the age of 12....and loves it! She is in better control. She does it all...from boluses to filling her pump herself! She simply amazes me! And I think it has given her confidence in herself. We still check up on her, as she sometimes will forget to check herself between meals...and she will be really high. But then, she knows the feelings between high and lows....and will correct what she needs to do.
I am 69 years old and was misdiagnosed as T2 eight years ago by my PCP. Rediagnosed as T1 with a positive GAD65 antibody test and a low c-peptide 2 years later by a wonderful endo and put on MDI at that time. My last A1c was 5.9%. My A1c for the last 6 years since started on MDI has never exceeded 6.3%. I just submitted an application to Medicare for a pump.
So WHY am I wanting to go on a pump? To further reduce the range of fluctuation of my BGs that only a finely-tuned pump regimen (or a working pancreas) can achieve. In so doing, I hope to reduce the number of hypos as well as the spikes. My A1c may not change but I believe that my well-being will definitely improve.
The 6 years of MDI have made me aware of what works and what does not work for me, including what I should eat and when, my various insulin and correction ratios, and the variations due to seasons and times of day. It has been an intensive process of self-education that includes testing at least 6 to 8 times each day. I hope that this will enable me to reach as safely as possible the tight control between BGs of 70 to 110 that constitute the normal range. Not pumping yet so we'll see...
Nora
Hi Everyone! I have had Diabetes since 4 years old, my husband has had Diabetes since 1 years old. We do 'fine" on insulin syringes-sliding scale. We are so tired of doctors/Endocrinologists wanting to put us on an isulin pump! Nothing broke, so why fix it? Our A1C's are 6.0-6.2. We do not beleive in pumps. We do not count carbs. We do not measure our food. We live like normal people with Diabetes. It's not a "hassel to inject in public, take out our insulin, syringes, monitor, strips, etc. before a meal. We do not like to have anything "stuck" in our stomaches, then move it around every 3 days. NO THANK-YOU! Although, the old beef/pork insulins of the 1970's ruined my upper arms/stomach. I wish there was a cure, but with only 1% going to cures of all diseases, we don't see it likely. We wish though!
To bad they don't get stem cells going! We think a lot of diseases could be cured!
There is so much "waste" on menial things for Type 1 Diabetes. There has been no
good things to come along in the treatment of Diabetes. We all still take insulin in one way, or another, we still check blood-sugar, it never ends! We need just the cure like yesterday! Pumps are no cure, even a new type of blood-less testing isn't around yet, and I don't mean a big, ugly, looking, watch! Well, everybody stay healthy, and stay active in whatever you do!
Obviously, you haven't spoken with pump users! The pump has changed my teen sons life, health and outlook towards a lifelong traumatic and serious illness. It has given him freedom that mdi's (multiple daily injections...to those who are educated) could not. We can sleep at night knowing that he is receiving the proper constant basel dosage that longacting Lantus and the like cannot be measured to do consistently. We can give our son a lower dosage of basal in the dawn hours to compensate for his hormone secretion, something l.a. cannot do. We can leave the house without freaking out when the ice pack wasn't re-frozen to carry insulin in the hot car or to a hot pool without bringing a cooler. How could the FDA think to go backwards when such amazing life changing pieces of equipment exist. AND how can you promote this without talking to all of the many, many success stories. We should not have to live in the dark ages for the mistakes of a few. This article is alarming to me on so many levels...shame on the FDA!!!!!
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Ann: Great followup to the meeting, with a look at some stats and your personal experience. Interesting to read all of that. Particularly given that I recently attended a JDRF event and the speaker, Aaron Kowalski who's heading up the Artificial Pancreas Project, said that Europe has something like a 90% coverage rate for pumps and CGMs from insurance there - compared to the less than half percentage here. That seemed pretty incredible, but if they're only paying for something that 10 percent uses, it diminishes the numbers rather quickly. Anyhow, I've been pumping for 9 of my 26 years with Type 1. Diagnosed when I was 5 years old and spent most of those injecting. For me, it's been a lifesaver - saw my lowest A1C ever of 6.1 in the year after starting, and it's only gone up because of my personal slacking on adequate care and utilization. But I've never had significant issues. Of course, each person is different. I personally think that no newly-diagnosed child or person should be put on a pump, but should have to spend at least a couple years injecting first. That allows for the person to at least learn the basics, and what needs to be done if pumping isn't possible for whatever reason. But, it's not a rule and only a personal philosophy I think is appropriate. Will be interesting to see what happens from all this at the FDA. Look forward to reading more of your stuff!
Hi Michael, thanks for your comment!
When I switched over to the pump, I too tightened up control, but then I slacked a little and my a1c went up. But it seemed like I had so many variables, other than myself, that the pump simply didn't work for me! So it raises the question does tighter control come from the pump or from management?
However, I am completely behind pump technology because there are sooo many times it does makes life easier and I think for parents having a cgm combined just simplifies many things for a family. But here's a great example of the problem, last summer a mom came to a group meeting and her son had just been diagnosed(2 weeks), and she was adamant about getting her son on a pump immediately! I felt she had not even gotten her head wrapped around the basics to decide, but she was absolutely clear, the nurse practitioner in the practice has said how much better her son would do on the pump. This blanket statement, and I hear it a lot, is where the problem begins!
My argument isn't with pumping, it's really when is it time to pump. The healthcare providers need to have time to invest in the education of their patients!! Why everyone must leap a pump, when healthcare providers are hard to reach when you have the flu, baffles me!?
I've been using pump therapy for 15+ years. I do have some syringes as backup, but have not had to revert to same.
Was diagnosed T-1 in 09/1967 and have (thankfully) no side-effect/problems to date. Albeit my maturity of 60-years does have me on lo-dose aspirin and a thyroid tweak.
I have also been using the Navigator CGMS for two years.
I appreciate all the studies and information for all of us ... but notice the numbers provided for EU usage, etc..
We, in America, have to be very concerned about the possibility of socialized medicine and what that will ultimately truly mean to us.
I won't say anymore ... save for just beware and watchful and read/listen/understand fully all sides.
Cheers,
Nolan K.
Plano, TX