Pumpers and More Pumpers

I have reading tweets from people who mention that they are new pumpers. I really am happy for them but there is a cautionary tale to this story. Pumps are not for everyone. They need to be assessed on a case by case basis. Do not let your self get your hopes up that a pump will fix all your issues with A1C or blood sugars.

I speak from experience in this matter. I was at first very against being switched to a pump since it is a man made machine that is not perfect and WILL at some point in the future break down. Every time the doctors (had more than one try to talk me into it) brought up the pump idea my response was the same. Over my dead body, I did not want it attached to me when it screwed up and almost kills me.

There have been many advances made in pump technology since it was first brought to my attention. Better, more accurate insulin delivery and the most important, better safety features built into them.

When I started to see my new doctor she talked me into finally trying a pump. They gave me a CGM sensor to get an idea on the proper settings for the pump. I was told there was a clear and distinctive pattern to my blood sugar levels. I was started out at 1.8 units per hour as a basal rate and my same bolus ratios.

The first week was a disaster. My sister was getting tired of calling the EMTs to wake me up with blood sugars in the 20s and 30s. They knew me by name and sight after that first week. Sadly it was not just at home I was having issues. I also had issues at work.

By the time they got the settings close to right it was set at 0.0028 units per hour in the afternoon and only between 5am and 11am was it nearly as high as in the beginning at 1.8. It changed several times over the next few weeks but was usually around 1.5 to 2.1 per hour. That’s big difference from the starting point.

Now I am not saying it should not be tried or used by anyone. Many people have good luck and it makes a big difference in their lives for the better. I have a friend who uses one and other than gaining a lot of weight from it she likes it and is happy with it. Oh she did have the same problem I did with lows in the beginning hence the weight gain. Now that it is better set she is loosing the weight.

I finally had enough of it and had the doctor put me back on regular shots and have been much happier. My A1C before the pump was 8 something and ended at 10 something after the first year on the pump. I am now back to the low 9s with A1C and with the new CGM device to keep me in the loop with my current blood sugar I am able to not eat at the first sign of low blood sugar. If it drops fast it is a similar feeling to it already being low.

Here’s my take on all this, I detest the term brittle diabetic but that is what I have been told I am several times by more than one specialist. I hate it because it make me feel less than human and weaker for being a diabetic. If I so much as look at a set of weights or think of a bike ride my metabolism goes up and my blood sugar drops fast and far. I have had it drop on my CGM graph from mid 300 to 70 in less than 2 hours. Because of how fast it drops I hate to see it below 100, thus I eat more than I should.

Now I have to give the down sides to the shot system as well. Once you take that shot you can not change the amount of insulin in your system so if your exercise rate increases you will have to adjust your food intake to compensate. A pump can be turned down to deliver less insulin when this happens. You just have to remember to do this when it starts or it will be too late. Once the inulin has been delivered there is nothing you can do but eat more to regain the balance.

Something that may have helped my situation is more training. I was taught the basics before even being allowed to put the pump on. Not just installing the cannulas but also being able to program the pump. However I was not taught the extra features like a squared bolus  until I had gained control and my sugar levels were close to normal. Problem was I never got even close to it being under control.

I got blamed for not writing down everything I was eating, it was a lot the first year, and not changing the pump bolus from work to non work. Yes that one I had an issue with as when did you make that change? Did you do it as soon as you got off the morning after work (3rd shift) or did you wait until your body adjusted to not working? Just how do you define that point in life? If you figure it out let me know because I never did.

Another issue I had with the pump was not being able to go swimming with it on. Or taking a shower. With shots I do not have to carry the cover with me to remove the pump from my port. The inserted part never leaves your body, you remove the tube part and twist on a cover to prevent water from getting inside the port. With the shot I don’t worry about it ever. Once the insulin is in I pull the needle out and put it away I don’t worry about water getting in or anything inside leaking out.

My experience with the pump was not a good one although I do have to admit I would have loved for it to have lived up to its promise of a better life. I have since then been asked about being willing to go back on it and my answer has been and will continue being no. “It will make it easier to control your blood sugars.” No it will not. I heard that same claim last time and it never came true for me. For what ever reason, brittle diabetic (there was a shudder up my spine as I wrote that) or not knowing how to work it right, it simply did not work for me. It even says in the information they give you that a pump is not for everyone. I had the cannulas ripped off me several times. I am an active person ad it got pulled off a few times but mostly I sweated it off in less that the 3 day life span of the cannulas.

I just wanted to let people know the pump may be your salvation for getting tighter control over your blood sugars but to not let yourself feel that you are now locked into it if it is not working. I gave it almost 2 years to work itself out and it never did. Now being back on shots I have better control and lower A1Cs than I did while on the pump. Will I ever go back to it? I might some day but there will have to be some kind of major break though on reading blood sugars and automatic control than the current ones. Think about where you are and where you want to be and use the BEST path to get there regardless of which one it ends up being.

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