Are Insulin Pumps Better Than Shots? (Continued)
What About Type 2s?
Type 2s aren't covered as well for pumps as T1s simply because they haven't been studied enough for anyone to be clear about which way the wind is blowing. But I'd put my money on the fact that anyone who needs MDI can do better on a pump regardless of the underlying physiological causes that got them there (and remember that most type 2s, in the fullness of time, will lose so much pancreatic function fighting their insulin resistance that they will need type 1-style therapy to stay healthy).
Oddly, at the clinic where I run the diabetes program, we have as many T2 patients on pumps as we do T1s. More oddly, they are doing super-awesome both compared to my T1s and compared to how they were doing on shots. So there you go. So much for Evidence Based Medicine.
What do I make of all of this? Well, here's the deal: the pump is just a fancy syringe.
The pump isn't an artificial pancreas. It isn't a miracle device. It isn't a cure-all. It isn't even all that smart. In fact, the key thing to remember is that an insulin pump, while it might replace your pancreas in the broadest sense, doesn't replace your brain. The pump, for the most part, is deaf, dumb, and blind. It doesn't know what's happening in your body beyond what you tell it, and it does very little automatically beyond what you tell it to do.
Pumps by themselves can't make PWDs healthier any more than syringes can. The only thing that can make a PWD healthier is the PWD him or herself. Both pumps and syringes are just tools.
All of that said, I do feel pumps provide the opportunity for better control than shots do. (See my top seven reasons why pumps trump HERE.) But I'm not sure we can prove it scientifically, because science can't quantify the great variable of the human on the other end of the pump. Diabetes, unique among diseases, is strongly influenced by behavior. Even the best tools have to be used well. But to try to use science to prove something so innately un-quantifiable as the human personality, is perhaps asking too much.
When it comes to equipping dFolk with insulin pumps, maybe we need to take a page from law rather than from science. Rather than proving pumps, maybe we should just ask: What does the preponderance of the evidence say? Is there any reasonable doubt?
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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