Thinking of starting the pump therapy.

Nana_anna
By Nana_anna Latest Reply 2013-02-28 18:16:20 -0600
Started 2012-08-27 18:15:17 -0500

I am considering the alternative of using the pump, as my Dr. is concerned with my numbers being high. I see that it is good for Type 1 diabetes, but can Type 2 diabetics use it to? Would this make a difference? Maybe for him, in keeping up with my highs and lows. Monitoring my BS on a better level for him. How would I play a role in this? I have heard about them only on line. I do not know anyone here, or any family that uses this therapy. I am researching on this subject, and found a lengthly article. Thought I would share it with you.

[ Cover image: Insulin injection. Computer artwork of a syringe, with other syringes and pancreases in the background. Credit: David Mack/Science Photo Library. ]

Insulin therapy using an insulin injection was introduced in 1922. Progress towards a more physiological approach to insulin replacement has been painfully slow. One advance has been the use of continuous subcutaneous insulin infusion (CSII or insulin pumps) with or without glucose sensor augmentation. However, this therapeutic option is expensive and requires a trained multidisciplinary team to deliver an insulin pump service. It is therefore important to consider who would most benefit from such therapy and its cost-effectiveness. The availability of insulin pumps as a therapeutic option for the treatment of diabetes varies both between and within countries depending on the health system and its affordability for that country.

In this month’s issue, Carlsson and colleagues (page 1055) examine the availability of insulin pump therapy in people with Type 1 diabetes attending 10 hospital outpatient clinics in Sweden. The use of insulin pumps varied between clinics and women were 1.5-fold more likely to use such therapy. Other features associated with pump use were a higher HbA1c at baseline, lower creatinine, high and low insulin doses, and younger age. People with Type 1 diabetes aged 20–30 years were two times more likely to begin to use insulin pumps than those aged 40–50 years.

In the UK there are national guidelines (the National Institute for Health and Clinical Excellence; NICE) that recommend consideration of pump therapy in people with Type 1 diabetes on multiple daily injections with HbA1c > 69 mmol/mol (8.5%) despite the person trying to improve their diabetes control or in those in whom target HbA1c cannot be reached because of hypoglycaemia. The recommendations are even more relaxed in children. NICE also states that insulin pump therapy should only be started by a trained team that includes a doctor who specializes in insulin pump therapy, a diabetes nurse and a dietician. It is then recommended that the therapy should only be continued if there is a sustained improvement in HbA1c and/or less hypoglycaemia; quality of life should also be added to this list. An audit of pump services is currently being undertaken in the UK but it is likely to find that access is variable between sites, with some regions still not having access to a pump service as the commissioners of health care will not fund the service that requires not only the cost of the pump and its consumables but all members of the pump team, including the funding of educational packages. The availability of an insulin pump for a person with Type 1 diabetes then becomes a post-code lottery. This is an unacceptable state of affairs.

Some patients with Type 1 diabetes do not want to use an insulin pump, but would consider the use of a continuous glucose monitoring system (CGMS). Unfortunately, there is no formal guidance on this issue in many countries, which makes it even more difficult for this to be considered an option, despite the wishes of those living with diabetes and health professionals advising on best practice.

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11 replies

red flower lady
red flower lady 2012-08-30 17:56:29 -0500 Report

If your numbers are not good and your current meds are not helping, then you could use a pump, it just depends if you meet the requirements. The pump company will ask you questions and then send it to your insurance to get approval. You have to carb count, know how adjust the insulin the insulin by what your eating, exercising etc. It will take some work and you want to make sure you don't run too low. You also might want to check on the cost of running a pump as it is alot more expensive then shots and most don't relize that.

Now, that being said, pumps can be wonderful, but they are not for everyone. I suggest you research them before deciding and ask to go to a class before getting one.

Set apart
Set apart 2012-08-30 06:06:00 -0500 Report

My doctor wants me to consider using the pump, not sure how I feel about it since I am trying to be very careful with fast acting insulin intake. I am however considering using the sensor for some of the lows I continue to experience! Does anyone know the benefits of using both pump and sensor as a duo? I am very sensitive to insulin, especially fast acting!

jvdsammy
jvdsammy 2012-08-30 01:53:58 -0500 Report

You will NOT believe how much freedom you will feel on the pump and how much your diabetes will improve! The pump is life giving! Say YES!

AnnRendon
AnnRendon 2012-12-14 14:17:10 -0600 Report

I believe it.. Are you able to eat more of the things you enjoy being on the pump? it seems like its almost like not having diebeties because it gives you what you need automatically..am i wrong?

kdroberts
kdroberts 2012-12-14 15:23:05 -0600 Report

A pump doesn't really give you anything automatically, it's all based on configuration you have to do and manual input. You have the basal rate that is delivered automatically to you but it takes time to set that up and it doesn't adjust, just gives you what you have told it to give you at the times you tell it to. When you eat it can figure out how much insulin to give yu based on your blood sugar and amount of carbs, but again, that calculation is done using setup you have to figure out. It won't give you anything without you fisrt telling it to.

jayabee52
jayabee52 2012-12-14 14:40:27 -0600 Report

well of one wants to, or diesn't care about packing on the lbs because using insulin (either injected or pumped,) cam put fat on a person's body. My recommendation would be to keep one's insulin intake at the lowest possible point by low carb eating plans.

Yes from what I've read here from pumpers on DC, you modify your eating plan or you'll suffer consequences from your fat build up. Talk to Type1Lou about it.

James

ShellyLargent
ShellyLargent 2012-08-29 12:52:04 -0500 Report

I'm a type 2 diabetic and have been on a pump for several years (off and on due to insurance changes). I love my pump. It takes most of the guess work out of keeping my numbers in check and has really helped me to keep a lot better control. I'd be lost without my pump. Before my pump, I was on MDI's of NpH and R insulin - NpH in the AM and PM before bed, R before each meal. The biggest problem I had was too many lows as I was not eating enough to match the insulin intake. I'd try to adjust my insulin amounts, then I'd be too high… It was a never ending battle to keep my numbers under control. With my pump, I rarely have a low now and because I test more often with the pump, if I start going high, I can stop it before it's too bad. I feel like I have a lot more freedom to do things now with my pump than I did before. There was always that constant fear of a dangerous low. Now that fear is minimal.

Gabby
GabbyPA 2012-08-28 11:46:55 -0500 Report

Why do you feel a pump would not work for a type 2 diabetic? As long as your insulin resistance is not through the roof, wouldn't it work for Type 2 as well as a type 1?

Nana_anna
Nana_anna 2012-08-28 13:38:16 -0500 Report

I am still learning about that. It's new to me. I have read some resources say that, type 11 does not need it because of the pancrease. But then some type 2 diabetics use it. So I am going to check with my Dr. next week to see what he thinks.

Gabby
GabbyPA 2012-08-29 10:48:58 -0500 Report

That is the best thing. Your doctor can work out a treatment plan that works for you and if the pump is part of it, then give it a try. Worst case scenario, you don't like it and you go to something else. There are a lot of discussions on the pump and how people feel about them. Maybe check a few of those out. Also look at the product review. There are specific pumps listed there, so you can ask your doctor about the ones that people like the best.