Pumping Insulin


with Amy Tenderich of www.diabetesmine.com

straightup-hiresI am the latest in a long line of PWDs (people with diabetes) to struggle with the question: to pump or not to pump. Since using an insulin pump means living with a medical contraption attached to your abdomen, the decision can be highly emotionally charged. It certainly was for me.

But a few weeks ago nearly four years into my new life with type 1 diabetes I finally took the plunge and became a pumper. Ive been lucky enough to be one of the first patients using a revolutionary new tubeless pumping system called the OmniPod. So far I like it a lot! Its made many things easier, but switching to pumping has also added a few new layers of complexity to my life.
Getting Here

Ive known from day one that the experts tout pump therapy as the most effective treatment for patients on insulin; clinical studies show that using a pump reduces the risk of long-term complications by up to 76%. Ive also heard testimonials from throngs of pumpers about how it has improved their health and quality of life. A pump allows you to fine-tune insulin dosing while freeing you from the pain and hassle of multiple daily injections. It provides better glycemic control, using lower doses of insulin, and reduces both glycemic variability (blood glucose swings) and the risk of hypoglycemia (low blood sugar).

But one big drawback (perhaps THE big drawback) has traditionally been the form factor: a pager-like device connected to your body 24 hours a day by a long plastic tube that can easily get caught or tangled.

Like many of you out there, I found the concept a big turn-off. Im very physically active and busy raising three spirited kids, whose hands, toys, and little tennis shoes are ever-so-likely to get caught up in the pump tubing and yank it out at some point. Cringe.

Still, as my A1c crept gradually higher and higher over the last year, I thought more and more seriously about the pump. Wasnt my long-term health worth some plastic tubing and a geeky-looking fashion challenge? (i.e. where to stick that pager-ish box tethered to me when Im wearing a dress or tight jeans or skimpy summer clothes, for goodness sake?) There was also the issue of exposing my diabetes since a visible insulin pump would surely invite a lot of questions.

For these reasons, Ive been holding out for the new OmniPod from Insulet Corp. of Bedford, MA. Its an innovative new system thats entirely wireless. Instead of carrying the insulin in the controller device, and pumping it into your body via plastic tubing, the OmniPod consists of two stand-alone devices. Theres a "pod" filled with insulin thats worn directly on your skin, and a separate hand-held controller device that also doubles as a blood glucose monitor. So when youre using it, you need only carry around one thing. Its also very discreet, since you wear the half-kiwi-sized pod underneath your clothing.

Bionic Babe

So I have become a pumper. I am woman, I wear pod. Despite the lack of tubing, I feel a little bionic with this not-so-tiny pod on my bod. One of my readers recently likened the pods to tumors bulging under your clothes, which did nothing for my faith in my continued sex appeal. Aargh. Luckily, my partner doesnt seem deterred in the least.

Meanwhile, Im adjusting to a new daily existence. A lot of people do complain that they gain weight, dont feel sexy, and/or experience severe blood sugar lows when they first start on the pump. So what will happen to me?

I am delighted that the pump is taking a lot of the math out of my eating. On shots, I used three different insulin-to-carb ratios throughout the day gradually increasing as my long-acting Lantus wore off. I used to carry around a calculator but still made frequent mistakes. The pump has evened out my dosing, and does all the math for me even suggesting corrections when I need them.

Ive realized that multiple daily injection (MDI) therapy is rather imprecise. I was killing myself chasing those glucose highs, mostly achieving nice moderate numbers right before the next meal. How frustrating is that?

My new pump sans the undesirable tubing is smoothing out my control by allowing me to do things like administer minute doses (0.4 and 0.5 units) and reduce my 24-hour basal drip during workouts.

But now Im knee-deep in learning all about how these complex settings work: temporary basals, correction factors, reverse corrections, IOB (insulin on board), etc., etc. Im forced to become yet another diabetic self-made scientist. So life with diabetes still isnt easy, just better less daily hassle in the long run, with improved results. I think I made the right decision.

* Amy Tenderich is co-author of the new book, Know Your Numbers, Outlive Your Diabetes.

dLife'sDaily Living columnists are not all medical experts, but everydaypeople living with diabetes and sharing their personal experiences.While their method of diabetes management may work for them, everyoneis different. Please consult with your diabetes care team to find outwhat will work best for you.

Read More About Amy Tenderich

Last Modified Date: November 28, 2012

All content on dLife.com is created and reviewed in compliance with our editorial policy.
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