Are You Happy with Your Insulin Pump?
March 2, 2009 6:12 PM   Subscribe

I am a 60 year old male who has had type 1 diabetes for 54 years. I have taken insulin injections every day since being diagnosed. For the last 30 years, I have taken 2-4 shots daily. Since the needles are now so thin and sharp, I don't feel pain with the injections, but it is such a nuisance to always have insulin and syringes with me and sometimes to have to find a place to inject. I am still fairly active (knock, knock) and am considering an insulin pump. Will you kindly tell me your experiences, good or bad, with your pump? Thanks!
posted by konig to Health & Fitness (7 answers total) 3 users marked this as a favorite
Best answer: Well, I'm a 21 year old male who went on the pump about 6 months ago. The insulin pump is the way to go. I had doubts: I actually thought taking shots was more convenient. Boy was I wrong. Take the jump; you won't regret it. I had to change about 15 years of habits so I can imagine changing 30 will be difficult. The key is to stay in contact with your doctor/team and to check your blood sugar nonstop. My A1C went down dramatically, needles are all gone, and the pump is a great conversation starter. Some downsides: i hate worrying that I'm going to run out of insulin; the chaning of a set is kind of complicated and requires a lot of parts. Other than that it's great. memail or email me for other questions.
posted by bobber at 7:29 PM on March 2, 2009

Not diabetic myself, but several of my (twentysomething) friends have been since childhood. All now have pumps. All of them grumble a little about them, but when asked say that they would never want to go back to syringes.

For the friend whose opinion of her pump I know most about, the main impetus for using the pump was that without it, she was having seizures in her sleep. Since acquiring her pump about seven years ago, she hasn't had a single one. She finds it much easier to keep her insulin/blood sugar levels on an even keel.
posted by ocherdraco at 7:38 PM on March 2, 2009

My partner (middle-aged, Type 1 since childhood) used a pump for a couple years earlier this decade. He had a serious reaction and was hospitalized when the pump malfunctioned (possibly due to user error after changing the battery). He went back on syringes. The last couple years he has moved on to using insulin pens, which he likes very much.

In his case, he never really felt comfortable with the pump, tubing, etc, and the effect that wearing it had on his body self-image. YMMV.

He also feels some skepticism toward Medtronic, particularly with their marketing practices, but that's not really germane to this thread.
posted by Robert Angelo at 8:19 PM on March 2, 2009

Best answer: A friend of mine does this stuff every day, so I asked her to weigh in:

I am an endocrinolgic nurse practitioner, and deal with Type 1 diabetics all day. Insulin pumps are the gold standard in our practice for Type 1 DM. I must disclose I am also a contracted employee of Medtronic Minimed, and a speaker for Sanofi Aventis.

Pumps are a good idea when you have a variable schedule: different mealtimes, variable sleep-wake cycles, different exercise at different times of the day, etc. because you can reduce/increase the volume of insulin being delivered at any given time. You no longer need that longer-acting (basal) insulin with a pump, because you've got a little bit infusing all the time (or not, as you can suspend the infusion for short periods of time). You can vary the volume of insulin you give to cover a meal, or correct a high blood sugar, depending on what your targets are, and how sensitive (or not) you are to insulin.

In our practice, we have patients on Minimed, Animas, Cozmo and Omnipod pumps. They all work. We don't start pumps on patients who don't want to "carb count", because then about half the features can't be used. You still need to check your blood sugars AT LEAST 4 times a day. If the pump fails, you have to use syringes for about a day while the pump company FedExs the new one.

It's probably best to do this in concert with an endocrine practice. I never touched an insulin pump before I started this job, and I was a registerd nurse for many years before I went back to grad school.
posted by jdfan at 8:45 AM on March 3, 2009

A relative used one of the pumps mentioned by jdfan. A pump failure put her in the hospital with symptoms that were initially diagnosed as a heart attack. She was under the long term care of an Endocrinologist plus a nurse practitioner who worked for the pump manufacturer.
posted by Raybun at 2:56 PM on March 3, 2009

Response by poster: Thanks for all your helpful responses...

I am curious as to how close we are to developing a pump that communicates with an (embedded?) glucose monitor and then dispenses the appropriate dose of insulin; an artificial pancreas so to speak. I'm wondering if a cure for diabetes might present before that technology comes along, however.

At my age and having had diabetes as long as I have, and having experienced nearly all of the health issues that diabetes causes, I don't believe that I will likely see any drastic change to my life now either way. But I am sympathetic to juvenile diabetics today whose future health and lives are on a ticking clock due to current poor diabetes management. I wouldn't want to see any of them go through the kinds of problems that surely otherwise await those with poor control. I may however, be getting out of the focus of this thread, and I will leave it there.
posted by konig at 9:14 PM on March 3, 2009

I've been using an insulin pump for about the past 10 years, and have been a type 1 for about 18. I started with a Disetronic HTRON pump and had that for about 4 years. It wasn't waterproof, and had a catastrophic failure after I accidentally took it with me into the ocean... it basically shorted out and pumped all of its insulin, about 180 units, into me all at once. The 48 hours after that involved a lot of OJ and testing, but happily not death. Disetronic is out of business now, and rightly so. Anyway, I'd recommend getting a water resistant pump.

I've had an Animas IR1200 pump for the past 5 and a half years. Its been a great experience, and the company has offered solid support throughout. I just completed the process of ordering a new One Touch Ping, also made by Animas. I highly recommend them.

Later in 2009 the Ping will be upgraded to include an optional continuous glucose monitor (CGM). The minimed pump already has one available. They use different technology, but the feature set is basically the same: you get near continuous glucose readings displayed on your insulin pump. I've used a stand-alone CGM for a few weeks and liked the extra data quite a bit - it really helped me even things out and find a couple of periods during the day when I was routinely not well controlled.

There are no closed-loop systems or "artifical pancreas" systems on the market, though they seem like a natural next step to the Ping and minimed systems. The big issues are that CGM's aren't perfectly accurate (or even close to perfect). Quite frankly, an inaccurate reading used by an automated system could kill you quickly. I don't expect to see a closed loop system any time soon, but maybe in my life time (I'm 30). I think stem cell treatments or other biological systems will happen on the same timeline, or maybe sooner.

If the question is whether pumping is worth it for a type 1, I think the hands down answer is yes. Ok, not hands down. If you have insurance, yes.

If the question is whether we'll see a closed loop system soon, I think the answer is probably no. I'm an optimist, but skeptical about diabetes technology. I was told 18 years ago that we'd "soon have a painless blood glucose monitor". We still don't. Furthermore, that challenge is significantly easier than a closed-loop system, and a lot less likely to kill you. Still, I there are now at least 5 or 6 insulin pump companies on the market and there were only two or three 10 years ago... competition is definitely progress!
posted by pkingdesign at 12:08 AM on March 5, 2009

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