Pros
- I found that I achieved much tighter control, with less effort. The pump has several profiles, so you can customize your basal (continuous) rates as needed. This allows me to fine-tune control to my body and lifestyle and adjust for illness.
Meals are more flexible, because you can take insulin any time you want. If you can't eat when you expected to, you can adjust your dosage, which might not be possible if you have taken long-acting. And you can compensate for certain foods by using different bolus schedules (ie square wave, which made the effects of pizza, Thai and Indian food easy to manage).
- You can adjust your bolus (the extra insulin you take to cover food intake) to cover larger meals or decrease for exercise. I can keep better control while being flexible and this way I fit the diabetes around my life, versus the other way around.
- Taking insulin in public is more convenient and discreet. If anyone does notice, they assume you have a pager. No more taking shots in the car or in dirty washrooms, while juggling supplies. And MiniMed 508 comes with a remote control and audio boluses, so you actually don't have to take your pump out of its case.
- You may not have to eat snacks if you don't want to. Some people on pumps don't have to, because the action of Regular/Humalog insulin is easier to predict than that of Regular plus long-acting insulin.
You may use less insulin - I use 10% less than I did on needles. This helps with weight loss because one of the functions of insulin is to promote weight gain.
I do not have to take a needle several times a day: I change my needle-less tubing every 3 to 7 days. I have left it in as long as 12 days without any infection, redness or loss of obvious insulin efficiency. I did not do this by design, but back when I was not paying much attention.
I have a reservoir of 300 units( when full) of insulin on me if I get stuck somewhere. I check to make sure that if I get low, I carry some with me. It is very useful to not have to carry everything all the time. (Although it is a good idea to carry some backup pump supplies, so...)
- You can suspend the pump if needed. The only danger to this is that you forget to un-suspend it! I would only use it if I was really worried about an insulin reaction and knew I had no access to food in the near future. It would be a better idea to program a temporary basal rate of 0.0 units for a short period of time. I do this during exercise.
- Increased control can prevent/reverse complications. This is supported by the DCCT and my own experience. I have had diabetes for 22 years, have been on the pump for 16 years and for most of that time have ignored the diabetes, ate what I wanted, and didn't take extra insulin to cover meals. I changed the infusion sites occasionally and that was it. Despite this, I have few diabetes related problems, have never been hospitalized except for a kidney infection, and have no signs of major complications. I could be lucky and/or my genes could be great, but I know the pump has made a big difference.
Cons
If there is a problem with the pump, blood sugars rise quickly, due to the fact that you have been on short-acting insulin (this is even more true of using Humalog in the pump). This can be very serious and, if undetected and corrected, can lead to diabetic ketoacidosis. The way to avoid this is to make sure you don't run out of insulin by checking the reservoir every day, checking the site for possible infection, which will impede insulin uptake, checking the pump and tubing for leaks or any other problems. Doing blood sugars regularly, especially if you feel weird for no apparent reason, is a great way to keep on top of any potential problems.
My pump has malfunctioned: I called my Minimed representative and had a new pump within hours. This has happened once, so I feel pretty confident in my pump. I did have a big problem when I dropped my pump, broke the syringe/tubing connection and did not notice. I was not doing blood sugars and was on holidays. By the time I checked my pump and realized I was leaking insulin instead of receiving it, I was in bad shape. If I had been doing regular blood tests and paying attention to my pump, I would have been fine.
Infections can be bad, if you get one and don't deal with it appropriately. The way to get an infection is to not clean the site properly before you put in a new infusion set or ignore any feelings of discomfort regarding the site. Sometimes infections happen no matter what you do, or thought you did , so don't ignore any redness, pain or swelling. If you can feel the site, it means you should keep a close eye on it. If you have 2 unexplained blood sugars in a row, consider changing your set.
Pumps and pump supplies are expensive (see link below), but sometimes covered by medical insurance, especially if they understand that they will save money in the long run. Often, continual pressure will work if nothing else will. The way you will feel and the improvement in your health and quality of life definitely outweighs the cost.
You have a device hooked to you 24 hours a day, and it is a clear reminder that you have diabetes. It can be annoying but I got used to it. Figuring out where to put the pump can be a challenge, especially with tight or tailored clothing. People hang it from belts, waistbands and bras, or put it in a pocket or a pump sock. There are several options and you just experiment until you find what will work best for you.
Having the reminder of diabetes can be a large pain, but really, we're stuck with it, so we might as well do everything we can to keep healthy. If having a pump is really traumatic, that probably means that you need to talk to someone about how you feel about having a chronic, annoying illness. I actually think this is more of a pro. Deal with it now. Read my Denial page. Having diabetes is rotten, pumps make it easier.
I think that the main pro, of much better control and feeling great, tips the balance and makes any problem, annoyance or inconvenience bearable. Each person is different though. For some people, the pump just does not work. For others, like me, it has been quite literally a lifesaver.
But the pump is not automatic and it is not a cure. It does not decide how much insulin to give you - it has to be programmed. How many basal rates you may need, what kind of boluses, what to do to account for exercise and how to deal with unexpected events is a trial and error process for the most part. You probably will not hook it up and have great control the next day. It may take some time.
I have days and weeks when nothing works. I have days that I hate my pump. But I really don't hate my pump, I hate having diabetes. The pump can be a reminder of that, which can be a good or bad thing. What it comes down to is that I have diabetes, and the pump has made living with that much easier.
For anyone considering the pump, I would say find a doctor who will support you, decide if you can manage it financially and then rent one, if possible. You will not know unless you try it.
My pump costs page might help give you a sense of the financial side of pumping.
camojo ink © 1998-2003
| Main Page | Diabetes Info | Insulin Pumps | | Janine's Pump FAQ |
| Pros and Cons | Pump Costs | Infusion 101 | Denial | Diabetes Links |