Before I embarked on my journey, with an insulin pump, I had been on multiple daily injections (MDI) for almost 15 years. It wasn’t until I began to learn about insulin pump therapy that I truly grasped how different the two were.
With MDI, I feel less training was given in order for me to manage my diabetes. I didn’t learn how to carb count or even have an understanding of what insulin sensitivity was. The main focus of my diabetes management was to administer my insulin (my doses were worked out by the doctor and diabetes nurse, based on my blood glucose readings) when I needed to take it and checking my blood glucose levels.
It was only with insulin pump therapy that I began to have a better understanding of my diabetes management. I had to undergo a process of training before I was given free reign with my pump. I had to learn how the pump worked and in doing so, I had to develop my understanding of carb counting, insulin to carb ratios, insulin sensitivity, and basal rates. All of which, I have, to be honest, I had no idea what it even meant. I think this is because the nutrition and diabetes management were explained primarily to my mother but this information was very basic and she very much had to figure a lot of it out for herself. This then carried on into my transition from the children’s hospital to the adults clinic.
The insulin pump, I think isn’t for everyone, it takes a lot of work to make it work. Diabetes management can be improved but it also takes the individuals being able to understand the ins and outs of their condition, how foods interact’s with their body as well as their sensitivity towards insulin.
There are many benefits, as well as problems which can arise due to wearing an insulin pump.
Some of these benefits include:
- No more MDI: A sense of freedom from having to inject daily. At one point in my diabetes life I was taking 5 injections a day and I think that was one of the most challenging things I’ve ever experienced. It worked well with my sugars and control but it tied me down in so many ways. Let’s just say the insulin pump came at the right time.
- Data Collection: The insulin pump is able to store a lot of data and when downloaded a clearer picture appears as to what blood glucose levels may be doing at certain times. With my pump (Animas vibe) it allows you to see how much insulin may still be on board in your system which on some occasions has helped me avoid a lot of hypos. There is also stored information on how much insulin is being administered daily over several days. If you can’t remember if you’ve bolused or not, then the pump also has a stored history bank which tells you when you last bolused.
- Doses: Meal time boluses can be planned out in accordance with the amount of carbohydrates you may consume for that particular meal.
- Sensor: The pump combined with a sensor, you can see blood glucose levels recorded every 5 minutes over a 24 hour period in graph format.
- Ease of mind: receiving insulin doesn’t involve dialing up a pen and then finding the perfect spot to inject. It’s as simple as pushing a few buttons and insulin is delivered to you.
- Cost: This only applies to my UK readers, but insulin pump therapy here is free! However, if you want to use a sensor then this is something that you will have to pay for yourself (which can get pretty costly).
Problems can also arise when it comes to being attached to an insulin pump.
Some of these problems include:
- To Tube or not to Tube – I’ve been hooked to many a door handle and had my insert ripped from my body (Not nice at all). I’ve had to learn how to conceal my tubing in a way in which it won’t be affected by my surroundings. So the question is, do you choose a pump with tubing or not? The decision is entirely yours. I suggest if you do choose a pump with tubing then take precaution, keep the tube concealed well under your clothes. There are so many cool diabetes undergarments that can be used to keep our pumps and tubing safe. One of my favourite undergarments for men, women and children is a Swedish company called AnnaPS
- Wear and Tear – Protect your pump! I think the picture below explains my reasoning for this.
- Changes: The insulin pump does require that you change your insert every 2 – 3 days when the insulin cartridge is running low. This is something that you get used to, it has to be done so you get it done!
- Ketosis: With pump therapy, long-acting insulin isn’t needed. Quick acting insulin is the only form of insulin used. I’ve had occasions where there have been occlusions in the pump tubing during the night and because there is no long-acting insulin available, it has caused my sugar levels to rise at a rapid rate. Acting and reacting quickly when the problem is spotted is essential to getting the blood glucose back in range and avoiding ketones in the urine or DKA.
- Breakdown: Pumps are just machines and they can malfunction. I’ve had many a time when my pump has malfunctioned. One of the worst case scenarios was when I was on holiday, I noticed a crack in my pump and salt water had entered the pump, destroying the battery. My pump wouldn’t come on and was making all sorts of noises but thank god I took a spare (please remember to do that if you go on holiday).
- Rotate: Remember to rotate you infusion sites as it can irritate the skin where the adhesive sticks to your body.
- Control: Of course we want to have better control when we first start pumping. However, this doesn’t happen straight away. It took some time for me to understand more about the pump in relation to my body. Your control will start to improve but it won’t be immediate. You have to work on it to achieve better control.
If you are thinking of starting up on an insulin pump look at both the pros and cons involved in managing your diabetes with this technology. Be prepared to work hard at it and most of all be patient with it, you may not get the results you’re after straight away. Nevertheless, don’t give up on it, you’ll get there eventually.