Insulin pump questions

[Meg0131]

I'm 18 and have been diabetic since I was 10.  My blood sugars have always been very controlled up until recently and my doctor recommends that I start using an insulin pump:

1.  What would I do when I get into the shower or go swimming?  Can it be easily removed?

2.  What are the disadvantages and advantages of an insulin pump?

3.  Any recommendations on what kind of pump I should get?

4.  Is the pump painful?

I have a consultation scheduled in a few weeks so I'm sure my questions will be answered but I'd love to hear your opinions.

Also, recently I've noticed that when my blood sugar gets really high that my mouth becomes really dry.  Does anyone else experiance this?

[JDRF-Team-cb]

I have been diabetic for 25 years.  I was on the insulin pump for one year 8 years ago, so I am not the best person to answer your pump questions.  But, yes it is easy to remove(you are right you will learn at your consultation) I have heard from many that it significantly lowers your HA1c.  I didn't think the pump was painful.  I am sure others will reply with much more information.  Good Luck!!

[JDRF-Team-LRS]

I'm another volunteer and even tho' CB used a pump for a short time -- a while ago, she's right!

I've been pumping for nearly 10 years and was diagnosed about 35 years ago.  Pumps now are smarter and easier -- for folks who are somewhat comfy with technology.  You don't need to be a geek to work one ;-) but some folks are just not pleased to work *with* technology.  I **love** pumping and find the occasionally YIKES! to be manageable in the larger context.

The pump has cartridge of rapid-acting insulin.  There's a little "hose" (tubing" attachd to the cartridge and also attached to an "infusion set."  The infusion set is the part that's physically attachd to us.  Almost all pumps use a standard "luer lock" system so that just about all the tubings are interchangeable.  The exception is the Mini-med Paradigm. It's also an excellent pump and it has a unique system that's not interchangeable.  Inserting the infusion set with a "insrtion device" makes it quick & easy.

I don't take shots QUICKLY, never did.  Never could get the hang of a nurse's quick jab.  ;-)  I have found that using an insertion device -- much like a lancet device for finger sticks -- allows me to get a quick, almost-always-painless insertion.  When I started pumping, those devices hadn't been invented yet, and I'd spend quite few minutes slowly inserting.  

Disconnecting is easy for showering, swimming, etc.  Some pumps are cleared for use in water.  My pump is, but I've added the blood-test attachment and that part of the device can't get wet. I disconnect -- shower or swim and then reconnect.  If I'll be swimming for a while or if I wanna soak in warm bubble bath, I keep my pump nearby & dry -- reconnect to take a little "bolus" and then continue my soak.  

Wearing the pump is never painful.  If I feel any discomfort it's a sign I need to change my infusion site.  Occasionally, I may get a "bad spot" that's uncomfy and so I change the site as soon as I can.  ALmost always the uncomfy spot is that I've hit a tiny capillary or something and once I remove the infusion set, I feel 100% aok.  Typically, I change every 3 days ... so in a year, I might go thru 120 - 130 sets/year.  Of that, perhaps I get 5-6 "bad sites" per year, so it's not common at all.

What do I love about pumping?  The "basal" (does the job of your long-acting insulin) is programmable so that we get just the right amount of insulin to keep up functioning -- if we don't eat!  Sooo, that means no more getting up at XXam to take long-acting shots.  No more *having to feed the long-acting insulin" and being somewhat forced to eat on fixed schedule.  When I want a little snack, I can take as little 1/10 of a unit.  I'd never have taken a shot that small -- so either I'd forgo tasting that treat or I'd take it & run higher because of it.  Now, I bolus as I go.  

To work with a pump, read and learn about carbohydrate counting.  That'll be helpful even while your taking shots.  KNowing how many grams of carbos are "covered" by one unit of insulin is part of the math you'll learn.  FInd the book _Pumping Insulin_ by John Walsh & Ruth Roberts to begin understanding the concepts.  Again, this book'll help folks with diabetes if they decide not to pump.

If you do begin pumping, please take this lesson to heart.  ALWAYS (**Always**) have extra supplies with you in case you need to change your tubing or site "not on schedule" (as in, my bird discovered that my tubing is as fun to chew on as a plant stem!!).  Or if you have a malfunction with the pump (it's happend 2-3 times in my 10 years of pumping).  What supplies?  The stuff for your pump AND ALSO a fresh vial of rapid acting insulin and syringes in case you have to take shots 'til you get home to more supplies.  Keep a fresh vial of long-acting in your fridget in case you break your pump and have to wait 1-2 days for the replacement (as in, I somehow dropped it and then it got run over by dump truck -- or some other life mystery ;-)  ).  The point is, that "Insurance" costs very little and gives us 100% peace of mind that we'll do just fine even if the pump poops out for some bizarre reason.

Hope this helps. ANd I hope you come to love & depend on pumping the way I have.  It's helped me a lot.

[JDRF-Team-JW]

I am also a volunteer on this forum and have been living with Type I diabetes for 12 years. I have been on the mini-med paradigm insulin pump for over a year now and it's working great. My A1c has come down and I feel much better and in more control. I agree with LRS above. There's a lot of great information in that post. I'm just adding my two cents in so you can see that many people are happy with their pumps. In fact I was very reluctant for years to try one and I did plenty of research on forums, such as this one (you may also take a look at insulinpumpers.org for a lot of valuable information), as well as consulting other sources (the "Pumping Insulin" book, as mentioned by LRS, is great!)

To answer your questions:

1. Yes the insulin pump is very easily removed. I just twist the tubing part right off and cover my infusion site with  a clear plastic cap. Technically you can be off your pump for up to an hour (I usually don't go that long, but I could if I needed to) without any problems.

2. Disadvantages: if it malfunctions it's just a bit annoying to go back on the shots and keep control for that 1-2 days before you get your new pump (mine malfunctioned about a year after I got it -I got a new one within 2 days). Another small disadvantage: sometimes it's hard to hide it -depending on what you want to wear, but it really isn't a big deal. The first week or so is a bit difficult trying to get adjucted and used to wearing the pump and just usual stress when dealing with something new, but trust me: within a week you'd be searching for it on your body 'cause you'll forget you're wearing it :)

Advantages: plenty! I looooooooooooooooove the adjustable basal rates and the dual & square wave boluses. They allow you to program your pump to keep giving you insulin for hours after you eat if you eat something that takes a long time to absorb (like pizza). With shots you'd have to take multiple injections for hours to match the slow raise in your blood sugar. At the same time it's great for when you're  excercising or are being more active (without having planned it in advance) -you can just reduce your basal rate and be confident that you won't drop too low. See, with injections once you inject your basal insulin (like Lantus for instance) that's it -it's in your body and you can't manipulate it. With the pump you have constant basal in small doses throughout so you can stop it, reduce it, increase it and manipulate it so it will match your activity level and lifestyle, not the other way around. Also, it's nice not to have to take constant shots. I don't look like I've been fighting with a porcupine anymore :) It's also nice to be able to give yourself a bolus without whipping out syringes, running to the bathroom or otherwise freaking out people around you. The pump is more discrete and it loks like a beeper or one of many different electronic devices people carry around these days so no one even gives it a second look.

3. I can't really recommend any one pump over another since I've only used one: the Medtronic mini-med paradigm pump, and my doctor picked it out for me. It's been great (other than that one malfunction in which the buttons just stopped responding and I had a "button error" which I couldn't get rid off -but other than that no issues at all).

4. The pump is not painful at all. Inserting the infusion set, especially with an inserter (which I would recommend you get) is much less painful than taking injections -and you only do it once every 2-3 days. Once the tubing is in you don't feel it at all. If you do, like LRS mentioned above, it may just be a sign that your site may need changing -but that really doesn't happen often at all.

As for your mouth being dry when your sugar is high: yes that definitely happens to me too. In fact that is one of my signs that my sugar is high. However I haven't experienced many high sugars since I've had the pump.

Here's the bottom line on insulin pumps: They're not permanent so trying them is not risky (you can always go back on injections in an instant if you don't like it). They really are great and give you more freedom and control than you could ever get on injections (trust me: I was the biggest skeptic ever!) Just remember that the first week or so may be challenging, just like getting used to anything new in your life but soon after you won't imagine how you ever lived without the pump. Most importantly: work close with your diabetic team and make sure you know what to do in case a problem arises (like how to get back to injections without disturbing your regimen, if need be). Take your time, be patient and ask a lot of questions. Believe me, it'll be worth it. Best of luck to you!

[lflisp586]

Hello -
I've been using an insulin pump for about4 years.  I've loved every minute of it, obviously.  I'm 19 and a junior in college, so I understand everything you're going through.  I think the comments people have made so far are very complete, but I just wanted to add these two things -
First, a pump makes flexibility possible.  In college, I only know people on pumps.  In fact, the times that I've taken a so-called "pump holiday" and used shots of humalog and lantus, I've wanted to quickly go back on the pump.
Second, I used to be a competitive swimmer, and I still swim a lot now.  Swimming with the pump is very easy, because you can get tape that comes in rectangles the size of the site to place over it when you swim.  They last for up to a couple of hours, depending on how you stick it on,a nd come off without ripping out your site.  It allows me to not worry about dropping low beforehand, also, because I can suspend or take  atemporarily shorter basal rate before a workout.
I highly advise using the pump!!
Good luck!!!!!!!!!!

[WarrenL]

The www.insulinpumpers.org site is no longer available. My browser gives me : BadHostname.

I will be looking for those sheets of plastic that can cover the silhouette site. My wife, Linda, is the type 1 diabetic. I have lived with her and diabetes for 39 years, now. She has been on the pump for nearly two years. With the pump, her A1C went from 6.5 to 5.2.  but I am concerned that she is too tightly regulated. She has been experiencing frequent bouts of hypoglycemia - about once a week. I think she should back off a little.

We are uninsured this year so I am looking for less expensive alternatives to MiniMed supplies and sky-high costs. Is it OK to refer to brand names on this site?