Can you get an insulin pump if you haven't started injection therapy first?

Katy May
By Katy May Latest Reply 2014-07-24 23:48:16 -0500
Started 2014-07-22 15:53:21 -0500

My endo diagnosed me with secondary (other) diabetes due to 1) genetics, and 2) drugs taken to combat other diseases. I have taken injections for other disease and given injections to my diabetic parents and grandparents. My endo now says that I need insulin since Metformin was a fail as well as diet and exercise. My job which is one that requires activity with the public—networking at Chamber meetings—breakfasts, luncheons, dinners, etc. In addition, my levels fluctuates based on the food being served—I am on a low-carb diet.

Do you think my endo would prescribe a pump for me rather than shots? It would make my life easier. I know of two that have meter/remote bolus options that would work well with my lifestyle. I already keep a close track of my blood glucose levels (pricking and charting), but there is no way I would be able to test and administer an appropriate dosage, and know the menu in advance—too many variables, in a room averaging 100-150 people. With the remote it would look like I'm checking messages or texting on my phone.

Anyone have any advice?

6 replies

Jeff82 2014-07-24 23:48:16 -0500 Report

As Lou said, you need to know insulin sensitivity before you can use a pump; only way to find that out is injections ( I know from experience) it's like finding out how many highway miles to the gallon a car gets, Once you get the sensitivity down, you are the definition candidate for a pump; someone who doesn't have scheduled eating times or diet written in stone who needs flexibility. In my mind, learn the injection sensitivity/carb counting/sliding scale dosage(all go hand in hand) and you are ready for a pump.
I have pumped since 2012, please let me know if I can help you in any way! (Questions, personal experiences, anything) Lou knows his stuff, and I'm not just saying that because he and I talk once in a while :)

Type1Lou 2014-07-22 18:11:15 -0500 Report

While the pump calculates the bolus dosage you need for a meal, it does so based on your mealtime BG and on the carbohydrate amount that you input for the bolus, so you'd still need to be able to reasonably calculate the carbs you are eating. Generally, insulin sensitivity (one of the settings in a pump) is calculated based on how many units of insulin you use per day. If you haven't been injecting insulin, I'm not sure how they would determine your insulin sensitivity factor. Have you posed this question to your endocrinologist?

Katy May
Katy May 2014-07-22 18:29:47 -0500 Report

Well, that is the endo and I are suppose to discuss at our next session the process of starting insulin therapy. He is my mom's endo and he already has her on a strict regimen of basal and bolus insulin therapy (he does not allow adjustments); however, my schedule is not as consistent as hers. Even though she still does it—she's been a diabetic for more than 30 years.

That's the reason I asked the question. So based on your response he would have to start the injections first and then move me to a pump.

The only issue I see based on my BG tracking is overnight basals—-my pancreas is still putting up a good fight so basal would have to be extremely low and possibly CGM.

I'm still on the meds that damaged my pancreas and my endo thinks my pancreas will finally give up the ghost, so he wants to start the insulin therapy before any complications set in from the fluctuating highs and lows.

Thanks for the response.

Type1Lou 2014-07-22 19:14:29 -0500 Report

I only started pumping in 2011 and had been on MDI prior to that. I'm now retired but when I was working, I frequently traveled for my job and also ate out frequently with inconsistent meal times. MDI worked well for me at that time. I was on Lantus and Novolog and I loved not being tied to the clock for meal times. Prior to investing in a pump (they are costly), you and your doctor may wish to see how you respond to insulin therapy. If it goes well for you, you can then pursue pumping. I love the added control the pump gives me.

Katy May
Katy May 2014-07-23 08:35:55 -0500 Report

Thank you Type1Lou for the information. I now know what to ask my endo at the session. I appreciate your advice.

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