Elizabeth commented on yesterday's Pump Nostalgia post, saying she has been type 1 for 38 years and has in the past resisted the idea of going on a pump. She wants to know what I find so thrilling about it.

For starters, and probably the biggest things for me, it's the precision and the convenience. As for precision there are a couple of aspects: I don't have to conform to a certain number of carbs to match my insulin:carb ratio. For example, like many people, I am more insulin resistant in the morning, so my insulin:carb ratio is lower. So if I'm having 45 carbs and my insulin:carb ratio is 1:12 and my sugar is within target, I can't take 3.75 units with an insulin pen. So I either have to decrease or increase the number of carbs or the amount of insulin and deal with the consequences later.

Also with respect to precision is the benefit of bolus units smaller than 1. A quick snack may only be worth 0.5 units. Or the "insignificant" carbs in things like sugar-free gum or a teaspoon of coffee creamer that can be taken care of with 0.2 units of insulin.

And then there are the tailored basals. With long-acting insulin like Lantus, you can't change the amount of background insulin you get based on the time of day. So folks with dawn-phenomenon or who are more or less resistant at certain times of the day can adjust their insulin intake instead of their food intake. Not to mention the benefits of knowing you have background insulin 24 hours a day. When I started taking Lantus I just did one shot a day. Then I got to the point where I didn't think it was lasting the full 24 hours, so I split my dose and took it once every 12 hours. With a pump, you don't have to worry or wonder about your medicine having run its course.

As for convenience, my pump is always there. I don't have to worry about leaving my insulin pen behind (which I frequently did) or go digging for it in my purse. It's just always there.

One thing this can all add up to is a lower A1C. I started on my pump in January 2008 with an A1C of 6.8. Less than three months later, I remained at 6.8, which my endo told me was excellent since most people tend to go up after they start pumping while their basal and bolus rates are being established.

This is why it works for *me*. I was eager to get started on a pump because I knew it was going to make life with diabetes easier for me.