Injections Versus "dumdumdum....the pump"...I am skeptical

I am looking for some honest feedback.  I don't like things to be sugar coated like what the doctors try to sell you or the pharmacetical reps.  I have had T1D for 20 years now.  I briefly went on the pump when I was19-21 (like ten years ago).  I remember gaining substantial wieght from it.  I remember that I had to wear something with a pocket in it for bed.  Right now I take 8 injections a day, and honestly it doesn't bother me that bad but I am trying to get prenant and I have heard that if you are pregnant Endo's don't like you taking Lantus?  I take Lantus, Novolog, and Symlin. 

Anybody out there that went through the switch and had good/bad experience.  How did it help? 

Thank you.

First off...."endo's don't like.." is as useful as "diabetics don't..."  The only 12 endo's whose opinions count are the one you have now, and the one you might have if you need to change.  Ask him... And ask your current OBGNN, and any "high risk" OBGYN that you are considering going to. You could probably do this with their office manager, or by internet to the Dr. And send them copies of your current A1c and other labs.   When I wanted to get a CGMS in the 3rd world state of Hawaii, I had to call ALL the endos in my insurance program to find ONE than was open to even considering  such a device for ANY of his patients... the others flatly refused, and only one was honest enough to say it was due to the time involved, the remainder felt there was no use in such a device. Period.

Well that doesn't sound like you had a lot of fun trying to do that.  I will ask my high risk pregnancy OBGYN what he thinks.  My Endo said that since lantus is a class C drug that they can't reccomend it for pregnancy.   So did you use lantus when you were pregnant?

Hi Nicole, I think there is a pregnancy group, so you should check that out too. There are several women on the site that have had successful pregnancies and at least one I did it on shots.

As far as the pump, I am writing from the aspect of a parent of a  4yo with T1. The pump has been a huge blessing for us. His insulin needs are very small, so the better precision and accuracy with the pump have allowed him to have much tighter control than we were acheiving with shots.  It is also so easy to adjust to different basal rates throughout the day. Also it is much easier with the pump allow him to snack (which you should think about if pregnant, depending on your morning sickness, you may need to eat little bits throughout the day or just find you do not eat as much as you expect to when you sit down.) Also, when corrections are needed, it is easier / faster (IMO).

I think you should go into the process with an idea of whether you'd like to give the pump another try or really don't. I'd still listen to the endo and perinatalogist with an open mind, but also don't get pressured into something you don't want to do.

I had a very successful pregnancy on MDI ... I took Lantus and Humalog. Working together with my endo, I decided to take the (small) risk of using Lantus during pregnancy rather than going on NPH, where I felt I'd never get my a1c to a good pregnancy level. But, my endo has tons of T1 pregnancy experience, so he had a higher comfort level with things like slightly higher post-prandial numbers (i.e., 140-150 instead of 120) and using Lantus. Basically, no one has done major clinicl trials to test Lantus in pregnant women. You have to understand you're taking some risk in using it for that reason. But, there is no clinical data indicating adverse affects, just unknowns... (I was pregnant 3 years ago, so maybe things have changed data-wise). My perinatalogist, with dozens of years of experience in T1 pregnancies, was also pro-Lantus. But, this was a major teaching hospital where they've been able to "collect" their own anecdotal data of pregnancies with different insulin types.

Good luck w/ the decision. With hard work, I'm sure you'd do great either way.

P.S. Last time I heard, endos weren't recommending symlin yet for pregnancy, but maybe it's changed in the last couple of years...

Well I wouldn't mind giving the pump another try if it is for the benefit of the baby.  I like the freedom of not having something attached to me.  What is MDI??? That is what my Endo said about lantus...not having clinical trials.  And you are right, I would have to go off of Symlin as well.  You had a normal pregnancy?  Is your baby a T1 too?

Thank you both.

If you don't mind giving the pump another try, I'd try it before getting pregnant. Once you're pregnant, there are crazy blood sugar swings in the first trimester that could make it hard to get your pump settings / basals right. MDI = multiple daily injections (i.e., shots)

My pregnancy with very healthy with no adverse medical problems. I wouldn't call it normal though b/c of the intense daily efforts I had to put into my blood sugars and the multiple doctors visits a week. (All b/c of the D)

The chance of your child having T1 too isn't related to the pregnancy itself. But, no my son doesn't have T1. But, it can be diagnosed at any age, so he's at a slightly higher risk of getting it one day.

Let me know if you have other questions!

Dear Nicole,

I'm probably a bit late, I dont come on here very often... but I have a 4 year old son and while pregnant, I used the pump, an Animas.  Currently I use an Animas One Touch Ping.  I was diagnosed with T1 when I was 18 (1993), and went on the pump in 2001, prior to that using Multiple Daily Injections.  I had my son in 2006.  So I had some years of pumping experience before conceiving, which I do recommend, for the reasons another poster listed.  But with the demands of a pregnancy and the CONSTANT monitoring and corrections it requires, I would completely recommend the pump.  Think about your 8 injections per day multiplying when it comes to corrections-- and with the pump you can correct in such small increments- it really makes a difference.  I did "well" throughout my pregnancy, never going above 6.8%, which is good for me, my diabetes has always been very stubborn and requires a lot of insulin.  By the end of the pregnancy, you are also taking at least twice as much insulin as at the beginning.  We all know that the tighter control that you have during your pregnancy leads to better outcomes so why wouldn't you make it a little bit easier on yourself by using the technology that helps you acheive better control?  We are considering another child now, and if I do start TTC, then I will definitely look into a continuous glucose monitoring system in addition to my pump to even better my chances at good control. 

My son was born healthy and did not have symptoms of hypoglycemia at birth.  He was a large baby (9lbs 7oz), but honestly, I'm not sure if that had to do with my diabetes or just that he was a big baby- he's been at the 95th% his entire life!  My practice was extremely supportive throughout the pregnancy, and it is a lot of work to be pregnant with T1, but totally worth it, of course!! 

I HIGHLY recommend the new book by Cheryl Alkon, "Balancing Pregnancy With Pre-existing Diabetes: Healthy Mom, Healthy Baby" -- It's really the first book written by a T1 mom who interviewed hundreds of women who went through pregnancy with T1 and pre-existing T2.

Good luck!!!


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