Insulin pump and effectiveness

[kneazlelady]

Hello again. Kneazlelady here. I finally, thank goodness, went to a dietician/educator who hopefully is going to get me on a pump. She has two brands: 1) Cosmo and 2) Minimed. She says that the pumps she uses are programmable with information, like the one that was mentioned in the tragic post about the pumper who died. I am trying to remain optimistic, but I am excrutiatingly frustrated with my health. I am also very nervous about going back on the pump. I was on a Disetronic that did not do very well. Anyone out there got information on these two pumps? I think they are the latest model. Oh--and this lady is also a Certified Diabetes Pump Educator.

[JDRF-Team-LRS]

Hi again, Kneazlelady,
I'm also a long-time diabetic and not a physician.  I've been pumping for about 9 years -- first with a Disetronic (which I loved dearly, and thought I could never love another pump as much), and now my beloved Cozmo (which I quickly came to love & be humbled by).  It's terific you're working with a CDE... and you're reminding me that I'm overdue to make an appt with mine!

Here's a great book to get from the library or to buy if you can afford the ~$20 (less than that at Amazon).

_Pumping Insulin_ by Walsh & Roberts, 3rd edition
ISBN 1-884804-84-5 Published in 2000.

DOn't let the title fool, you.  Even tho' it's mainly for Pumpers (or folks getting ready to pump), it's got LOADS of handy tips & tricks & reminders for folks doing multiple daily injections (MDI).  They include handy formulas for computing insulin-carb ratios (how many gm of carbs 1 unit will "cover" wihtout us going too high or low), and insulin sensitivity factors ( how much 1 unit will drop our BG).
  

Since you didn't have a good experience when you were pumping before, I think it'd be important to understand WHY.  If none of the factors has changed or will change, then it seems fruitless to pursue the same path again.  Howwever, it's possible that some of your bad experiences were due to current features not available at that time in pumps.  If you didn't really understand insulin-carb ratios and sensitivity factor when you were pumping, I can see that the experience would be randomly successful at best.  These 2 ideas are nearly 100% of the basis for pumping!

Check out this site:
http://insulin-pumpers.org/links.shtml
scroll down & you'll see links to individual pump mfgrs' websites and a current (2004) pump feature comparison page.  It's likely more information than a person can digest in one pass, but it's handy reference as you learn more ...

Good luck.  Be true to yourself.  If you're interested & motivated to learn about pumping "in general" you can then consider the features of all the good pumps out there.

[kneazlelady]

OK another question. I am type 1 and you would think I would have some clue as to what I am doing, but I have been feeling like a beginner lately. Sheesh. My question is this: how does one figure out an insulin/carb ratio? I am checking very frequently (as much as insurance will deign). I have no c-peptide; I am not producing any insulin. Thing is that I am extremely sensitive to exercise and insulin still after 23 (almost 24) years. It's like doing a shot when I go for a walk which is wonderful but then I get extremely low.

[kneazlelady]

Hello JDRF team person, I'm sorry about the long post.
Thank you for your response! I'm about to check the sites you included in your post. I liked the Disetronic, but I had some truly frustrasting incidents with unexplained highs and lows. Being true to myself is tricky at best--part of my lack of success on the pump was the feeling that I could never really know for sure that what I was doing was going to work or not. I understood carb counting, but I got conflicting advice from one specialist to another, often resulting in extended high blood sugars (which I absolutely loathe beyond description). After feeling wretched for an extended period of time, I think I lost the trust in the people who were supposed to be helping me. I allowed myself to think that they were only making me high all the time because they couldn't handle a lawsuit if I got low on their watch. Not actually true. I also was never sat down with and explained how to understand the manipulation of basal rates myself. The implication was that I was to trust inherently the pump expert and not do anything myself. So I internalized the idea that somehow I couldn't learn how to truly manipulate my own basals and boluses without disastrous results. Not actually true, either. I need to learn and am able to learn...heck...I'm almost 30 years old for goodness' sake! Thanks again, and thank you for your response. And sorry about the long post.

[JDRF-Team-LRS]

I have a feeling you're going to do fine this time around.  Your approach & self-awareness are terrific.  No need for self-bashing or past-bashing ;-)

Truth is, even with pumping, things go wrong -- bad sites, crimped cannula, air in tubing, beastly hot day (gotta check into those Frio pump chillers, BTW)  They're a godsend on a hot day.

The company, Frio, is based in the UK, but here's their US website:
http://www.frious.com/

I have no financial connection to them, but I love their product!