When we say that an insulin pump provides better control, I think we should think about that statement. Are we telling others who don’t have a pump that they would have tighter control with one? Pretty much, right? That’s not necessarily true though, is it? If it were, I’d be on a pump according to my A1c and standard deviation results. And in the past while I was on a pump, it would not have made sense to say I was on a pump.
It’s one thing to say that “For me, an insulin pump provides better control” because then you’re talking about your own experience. It is my hope that people on pumps everywhere will realize that many people are achieving very tight control without a pump and therefore it’s more helpful to stay away from comments like, “An insulin pump provides better control”. Do you know what I mean? It’s a general statement that might give someone without a pump the wrong impression about what is possible in their own lives. I’m all for everyone having access to a pump, I wish everyone could at least have the chance to try it out, but what if someone doesn’t have access to one? We should avoid giving them the idea that their multiple daily injections (MDI) are not enough. If that is all they can get right now, don’t we want them to feel empowered to make MDI work? For their own well being?
In some cases if someone can only get access to the older, slower insulin, then it still serves them better in the meantime if they believe that with a disciplined schedule, they can achieve good glucose management. Yes, they deserve the opportunity for the flexibility a pump can give but if they don’t have access to that opportunity, isn’t it best they feel empowered to do what they need to do for their health? And flexibility or no flexibility, I still think better glucose is more valuable-but maybe that’s because I’ve felt what unmanaged blood sugars can do. I also endured the rigorous eating, snacking, sleeping, and waking schedule of R and N insulin of the past and in the end it wasn’t as bad as the unmanaged blood sugars. I say this because of the complications that arise from high blood sugars.
A pump doesn’t provide better control or worse control anyway, it’s really up to the user. Same goes for syringes and vials of insulin.
Does the pump add convenience in particular scenarios? Totally! Do syringes or pens? I’d say so.
An unfortunate side effect of all this is people giving me pity or assuming I’m poor because they learn I don’t use a pump. Or they assume I don’t use one because I’ve never tried it and fallen in love with it. I get emails from very sweet people trying to convince me to use a pump. But I did use one for seven years and so I know the pros and cons. While on the pump I literally felt I would die if it was taken away from me. Then I tried to be without it and realized that what made diabetes difficult was not the shots, it was the variable nature of blood sugars and that with or without a pump, I was still being challenged to control them. And after five years of the best blood sugars I’ve ever experienced, a wedding, a honeymoon at the beach, and a twin pregnancy, I really don’t miss the pump at all.
So let’s be accurate and supportive of better control, however one achieves it, because a pump being synonymous with great diabetes management is another one of those myths circulating out there. And it’s a harmful one.