Wil's Top Seven Reasons Why Pumps Trump Shots
By Wil Dubois
Years of clinical studies have had a hard time pinning down the complex issues of why pumps greatly improve health outcomes for some patients, but apparently don't help others much, if at all. Of course, humans are complex creatures and aren't readily put into a test tubes to be studied by science; and at the end of the day, an insulin pump is just a fancy syringe. A tool (albeit a very complicated one), nothing more.
So what is it about this tool that gives the user the potential to control his or her diabetes so much better than with shots? As a veteran pumper, and a pump trainer, here are my top thoughts on why pumps trump:
1) Micro-management of insulin volume. Pumps allow a wearer to easily and accurately take very small amounts of insulin when needed. It's possible to take a tenth of a unit of insulin with a pump. You simply can't do that with a syringe or a pen. The best you can get out of those two is one-half unit. Maybe. To be honest, it's sometimes hard to accurately get a full unit out of them.
2) Math made easy. Most folks taking shots use only one insulin-to-carb ratio all day long and one correction ratio all day long; but most people actually have different needs morning, noon, and night. For improved control, a pump can be pre-programed to change the math behind the scenes based on the time of day.
3) Better basal for the bod. MDI users take one or two extended release basal insulin shots per day to cover the periods between meals and overnight. The problem with one-size-fits-all is that it doesn't. Pumps dispense with basal insulin and provide for the body's basal needs with a constant drip of fasting-acting insulin. That drip's rate can be changed from hour-to-hour, creating what is called a basal pattern that better suits the needs of an individual's body.
4) Machines have better memory that we do. I'm half way through my Big Mac (regular readers will recall that I'm a better tour guide than a role model). Did I remember to take my shot? It may sound crazy to those of you who don't use insulin, but after a couple of thousand shots they all sorta blend together and sometimes you can't remember if you just took one ten minutes ago or not. Now you need to pick one of two bad choices: go without insulin and risk going too high; or risk doubling down on your insulin and going too low. With a pump you can ask it, did I just take some insulin? Pumps can even be programmed to remind you to take your insulin if you're the absent-minded professor type.
5) More flexibility. You can't undo a shot of basal insulin. You can, however, turn down your basal drip from a pump, using a temporary rate. So if your car broke down and you are getting some unexpected exercise, you don't need to add hypoglycemia to your bad day. You can also have different basal rates for different days of the week (most of us are either more or less active on weekends than on weekdays, for instance). And you can easily take very small corrections on a pump any time you check your blood sugar; something most people taking shots can't be bothered to do as it's so much more time and brain intensive. I'd bet 98% of MDI users would blow off a blood sugar reading of 130mg/dL (7.23 mmol/L) but an extra button press for a pumper will set things straight.
6) Embarrassment-free diabetes. Pumping is more discreet than shooting up, even more so now that everyone under the sun has a cell phone on their hip! I'll whip out a syringe at Furr's Family Cafeteria, but I know a lot of PWDs who won't shoot in public for a wide variety of personal and professional reasons. Watching a pumper take insulin for a meal looks so much like a woman texting her kids that no one even notices anymore.
7) Joy. Pumps make people happy, the one and only thing every study on pumps vs. shots agrees on. And a happy patient is a motivated patient. And a motived patient is one who will keep up with his or her care.
Wil Dubois is the author of four multi-award-winning books about diabetes. He is a PWD type 1, and is the diabetes coordinator for a rural non-profit clinic. Visit his blog, LifeAfterDX.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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