Tag Archives: pump vs shots

My Biggest Worry about Pumps

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“Ketones” by Ana Morales

 

I’m all about people using pumps if they like them (or don’t like them but find they manage their diabetes well with them).  It’s a wonderful device and I’m happy technology like that exists for us.  I used a pump for 7 years, which is plenty of time to experience just what pumping is all about.

So I want to talk about something I noticed during my pumping years and after them.

It occurred to me recently that my numbers rarely go high enough to induce DKA.  I can count on one hand the occasions in the past 5 years where my blood sugar has gone over 350 and it hasn’t been over 400 in 6 years.  I’ve been off the pump for 6 years and find I can’t go back, yet.  One of the most dangerous things in my mind is DKA and very high blood sugars.  I experienced super high blood sugars enough as a teenager to know I never want to go through that again.

When I was on the pump, it was a regular monthly occurrence to have a 400+ blood sugar reading and it was almost always due to a pump or tubing or pump site malfunction.  I knew that my being human provided sufficient variability and error to my diabetes management and I began to seriously resent the pump for adding to that risk simply because I didn’t have the energy to keep up with it’s extra requirements.

What I mean is people who don’t endure these pump issues have very good discipline when it comes to changing their pump site and checking their tubing and changing the site when they suspect they need to.  However, I know that many of us don’t do this.  I completely understand why-it’s hard to keep up this kind of diligence, especially if it means inserting a painfully long needle more times than we’d like.

Those who use pumps should probably be in a very good place when it comes to their motivation to do all that is necessary to successfully use the pump.  I was not one of these people because I resented wearing the pump and as a result, kept my site in too long sometimes and suffered the consequences.  Of course, sometimes, we can do everything right and something wrong can still happen with the pump though the likelihood is very much decreased if we keep up the right routine.

I love using syringes because I get piece of mind each time I give insulin, knowing I don’t have extra variables to contend with (there are SO many as is).  And mostly because I never have a high blood sugar surprise that is a result of my not receiving any basal insulin for a mysterious amount of time.  The danger of very high blood sugar isn’t just that, it’s also the lows that can result from giving insulin over and over again in an effort to push that really high and resistant blood sugar down.

Obviously there is more involved in keeping blood sugars stable.

Reducing my carbs and using shots has made my blood sugars so much more stable, with little extra effort involved.  And to me that’s practically miraculous in terms of gains to my quality of life and health.  So while I don’t mean to say that people shouldn’t use a pump I just think we should each be honest with ourselves about how it works for us.  I realized I was no longer a good candidate and got off the pump and there is nothing wrong with that.  And there is a good possibility that one day I’ll get back on a pump.  They are making wonderful improvements to pumps each year and I’m becoming a more responsible and disciplined person each year.

Very well meaning people tell me all the time, “but don’t you miss being able to sleep in and eat when you want?”  News flash my friends, there are now long acting insulin such as Lantus which serve as a basal insulin.  The NPH and R insulin of the past are just that.

I guess what I’m saying is, are you having a lot of extremely high numbers due to pump issues? If so, work to reduce them with your healthcare team and if you know in your heart that you aren’t keeping up with site changes and all the pump requires, think about your options.  Whatever you do, do it in favor of your health.  Everything else will surely fall into place.

Why you don’t need an insulin pump

 

Perhaps my most controversial post ever, let me begin by saying this is not about bashing insulin pumps.  I think they are a nice tool and a great piece of technology.  They’re just not great enough for me to use.

Nothing can compare to a fully functioning pancreas (duh) but, I find it interesting that most people I have talked to who have insulin pumps say they couldn’t live without it.  They mean it, too!  I understand.  I used to feel this way.  Yet, now that I’ve been off of the pump for a few years I realize I felt that way because of fear.  I can assure you there is nothing to be afraid of.  Please read on to find out what exactly I’m making a fuss about.

I recently heard someone say, “if you aren’t on the pump you must be crazy!”

Oh really?  Let’s be more open minded here.  First of all, why does it matter to me that people out there feel this strongly about having a pump?  Well, because of the negative power these words might have on an individual who cannot afford a pump or who for some reason or other cannot get access to one.  People should know it is very possible to manage their diabetes without one if that is the hand they are dealt at the moment.  I would hate to think some people out there feel they don’t have good control over their diabetes because they can’t get a pump.  This isn’t true but, they might be lead to believe it is.  They need empowerment and those of us who feel strongly about using all that modern technology has to offer should think twice before speaking.

Even my own doctor (I refer to him as my ex-doctor) laughed at me when I told him I wanted to get off of the pump.  He said, “nobody goes backwards, people always want to seek to improve their blood sugars, not disturb them”.  He disturbed me!  What ignorance!  (Its ok, he wrote about me later as a case example of a diabetic who did better coming off of the pump-although he still doesn’t understand how or why)

How come I  have A1c percentages in the 4-5% range (non-diabetic range) without a pump?  Is it assumed I’m doing something wrong?  I assure you my blood sugar is typically around 100 instead of swinging up and down.  So, there is one person’s proof they can do very well without a pump.  What about others?  Mary Tyler Moore doesn’t have one.  Many professional athletes don’t either.  Does this mean they are crazy or that their diabetes management is out of control?  I doubt athletes can perform well without controlled blood sugars.

There are valid reasons to choose not to have an insulin pump and those reasons should be recognized.

After several years scar tissue buildup becomes a serious issue for many people on the pump, causing changes in insulin absorption.  The famous Dr. Bernstein has said that after about 7 years on the pump, scar tissue is likely unavoidable and a real barrier against insulin absorption.  Interesting…I found my glucose numbers swinging mysteriously during my 6th consecutive year on the pump and decided to switch back to prehistoric syringes after 7 years.  Those glucose numbers stabilized with syringes.  Dr. Bernstein in fact, doesn’t even recommend insulin pumps to any of his patients.

I observe that there are more ways for a pump to potentially mess up your glucose than a syringe and vial of insulin.

Let’s take a look:

The syringe needle could break off (although it has only happened to me once).

I can’t think of more possible ways a syringe can go wrong.

The vial of insulin could be dropped and broken (I’ve dropped vials everywhere and luckily never broken one).

The pump itself is an imperfect machine which can go wrong (it may not go wrong, but the point is the potential is there-and I know it happened to me for no apparent reason more than once-a total mood killer when you hear the mad beeping).

The pump’s tubing can have air bubbles which cause high blood sugar if not caught in time.  You bolus for a meal and you think you are getting insulin when in fact all you got was air. (This also happened to me a couple of times, enough to infuriate me all the way to China).  The tubing can also knot and prevent insulin from reaching you. (I hear this often happens to active children and teens).

The pump’s battery might run out (obviously it warns you well ahead of time but, it is another thing to deal with).

You know, some people have told me, “well, at least with a pump you don’t have to carry anything around”.

I’m sorry, did I hear that correctly?  Does this mean you don’t carry around some form of sugar, emergency glucose gel, or glucose testing device?

For me, adding a small batch of syringes and a vial of insulin to the above required items is too easy.

Something I found negative in a pump was only an issue when tied to a specific person’s tendencies.  I call it being, “trigger happy”.

I gained a lot of weight when I first got on the pump the summer before 11th grade.  I was so excited to have insulin on me at all times and had heard the pump pitched to me as a way to eat whatever, whenever I wanted.  (Obviously not good advice.)  Problem was, I snacked just because I could do it so easily.  I also would give insulin when I suspected a high blood sugar and instead of testing first, I gave insulin with the pressing of a few buttons.  It was just too easy.

Now obviously this may not be you or most people.  Yet, I know I’m not the only one this happened to and honestly, I felt very free when I switched back to shots.  I thought twice before throwing something in my mouth because I had to give an injection for it.  I felt relieved that I was no longer addicted to the all too convenient buttons on the pump.  Again, I recognize this isn’t an issue for everyone.

Some people may feel that they enjoy the convenience of hitting buttons and enjoy snacking often.  Remember though, the more often you give insulin, the higher your margin of error due to a higher rate of incidence and the more unstable blood sugars you will have throughout the day.  This is scientific fact-not my own idea, and it has been talked about before.

I also wonder that if because insulin pumps make certain people so much money, insurance companies, doctors, and hospitals all end up promoting them over shots.  Just a thought.

Let me reiterate again that I am not against the pump.  If you have one and control your blood sugars well with it then that is awesome and I couldn’t be happier for you!  I am simply making a case for the cheaper, not-so-nifty, yet always reliable syringe which is so often made to look as the inferior alternative left for poor or unfortunate diabetics.

Thanks to syringes I give the exact amount of insulin I am intending on giving-every time.  This is priceless for me.  The fact that I can keep things simple and achieve great glucose numbers without something attached to my body is freeing for me.  I just want others to know that if they cannot try out a pump, don’t despair!  You can still manage your diabetes just as well with shots-if not better.  The goal for all of us diabetics is the same.  We deserve to freely choose how we reach that goal.

I know this struck some nerves so lets talk about it.  Just leave a comment :)

 

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