Pump or Pens?

We went to our second follow up today and after 6 weeks since dx my girls A1C is 10.1 from 13.4 at diagnosis. Her two week BG average is 122. All the worry and stress has paid off. We are discussing a pump to get even better control but now I am not so sure about her being tethered to a machine all the time. I would really like to have a CGM to see trends but a pump doesn't seem so good. 

Of course I wouldn't be the one wearing it and my daughter would love one since she now has a couple friends with them. I am not convinced. 



i love my pump. i can make changes in much quicker time. for instance, last night i was nervous about my first day at a new job today, and the adrenaline was pushing my BG up. I noticed it, and then i just upped my basal rate by 20% for the next two hours until I would be asleep. With MDI, I would have had to take a shot of humalog, which would have put around 2 units in my body and sent me low and then rebounding back up. 

I can lower the basal rate for exercise or alcohol. I can now eat foods with good control that i could not on mdi, like bagels, muffins, pasta, cereal... 

I have refused to by pocketless clothes since well before i was diabetic, so getting another electronic into my back pockets is not a big deal for me. the most annoying thing is lowering my pants to change clothes or go to the bathroom, but I either do the tubing yoga and it's okay, or I just disconnect really quickly. 

on mdi, i was forced to eat to feed lows often. i couldn't skip meals (i was on lantus and humalog, but it just didn't work out.) without going low. i lost my sensitivity to lows - i would be 32 and have no idea, just barely noticing that the hill was harder to climb on my bike than usual. 

on my pump, i can go all day without eating. if i start to rise because my liver is kicking out sugar, i can correct that easily. the IOB feature makes me way less likely to stack insulin and get the scary lows i was getting on mdi. 

but the immediate and huge difference for me was that all of a sudden i could eat fruit again. I didn't have to decide whether it was worth the shot and then try to draw up a half unit of insulin in order to eat an apple. it made me feel like diabetes what something there, a part of me, that i deal with, but that isn't all or even most of me. 

CGMs are really useful tools but can be maddeningly frustrating. Also, I don't think a CGM would have helped me on MDI much at all. I use it mostly for detecting lows before they happen, so that I can drop my basal rates and not have to feed the low; and for figuring out basal rate changes - which you can't do with shots. If you just want it for hypo unawareness or for alerting to highs earlier, then by all means, go for it. But if you had to choose between a pump or a cgm, i'd recommend a pump 300%. I believe a pump will help her control much more than cgm will. 

Of course, pumps aren't for everyone, but if your daughter wants one and thinks she is ready, i say go for it. If it doesn't work out, it doesn't work out, no harm no foul. But if it does, it might be a huge step forward in her diabetes management. 

Good luck with the decision. 

This a very thoughtful reply. 

What does mdi mean?

pump... user friendly, less pain, you can give insulin more often without feeling like a dart board, and if your daughter doesn't know how to give shots then its much easier if she wants to go out!

MDI=multiable daily injections

All I gotta say is that the pump changed my life.  I have had diabetes since I was 11 months old and did the injections from that time until 3 years ago when I got the pump.  There is a kid that lives in my neighborhood that has a pump and he is 16 and loves his pump.  He got it right when he was diagnosed.  Yeah theres a machine on your belt, but the benefits are totally worth it in my opinion.  Ask the doctor about it and maybe try it and see what you think.  See how it works and go from there.  I think you will be pleased with the results.  Good luck.  Its a big decision but one that will make life so much easier.

To tag oto my earlier reply, I was taking 8 to ten injections a day and it wasn't enough.  I went to the Dr to begin the pump process and my A1C was 12.  It was no wonder I was always feeling sick and no energy.  Injections meant I had to be very regimented and being a wildland firefighter, I just can't bail off the line to eat and take an injection and leave my fellow firefighters one man down.  The tube yoga, I like that by the way, is something to get used to.  I had to learn to sleep in regular shorts with belt loops instead of sleeping shorts with no loops, but that was easy.  I have had the tube get snagged on brush and ripped out while working in the brush, but I over came that by cutting little hole in my pants pockets and rerouting the tube.  It sounds like a big hassle but to feel better and have my A1C go from 12 to 7.2 in 6 months, the decision was the right one.  The only side effect I have had from the pump is that I gained weight because the food I was consuming was being processed correctly and going to the places it was supposed to go.  SO what?  I eat an apple instead of potato chips and carrots and celery instead of peanut butter and crackers, (that was a hard one to kick since they are so tasty).  The ease and simplicity will amaze you.  I was hooked the dayI got it and the next day felt better than I had in a very long time.

I am just the opposite. I think my daughter would benefit from the pump greatly but she doesnt want one yet if ever. I wont push her just in the past 2-3 days she has been giving herself her own pen injections all day long. Still going through 300 units in 2 weeks is a lot of pokes.

She's still pretty new to diabetes, Jessica. Doesn't mean that she will necessarily ever decide she wants a pump, but I know my first five months, i was SO anti-pump. I didn't even want to use pens! 

Then i started learning about the studies that show better control and decided I'd try it, but I didn't really expect it to work for me. I was wrong, and wish I had switched sooner. 

But I think you're right not to push her. At her age, if I had been diabetic and my mom had suggested I get a pump I would have hated the idea simply because it was my mom's idea. I was a difficult preteen and teen. 

I was anti-pump for the first 19 years I was diagnosed.  After I got the pump, I wondered why I had been so hesitant to try it.

"Tubing Yoga".... that's a good term for it.  Ha!

I was a little nervous when I first got my pump, I was 11. The "attached to a machine" is an interesting mind set to work with. But it is really no different than being attached to a bag with all your stuff in it in the end. I love my pump, everything got "easier". Short trips, unplanned snacks, late lunches, all the issues with time management that make diabetes ridiculous to deal with, they all became easier to manage. My mom didn't push me, but she did insist that I try one for a little while to see how it went, even though I wasn't super excited about it. But after a couple of weeks, I totally changed my mind, and wouldn't give it up for anything!

i love my pump and so do my parents. It helped me with my bg immensly and i love the freedom with the pump. I have had my pump for three yearzs and still love it. With the pump you have so many options to keep your bg in better control wich in turn will be better for your daughters overall health in years to come. I wish you the best of luck in your decision and hope you are happy with your choice.

I love the tube yaga LOL.  I am troubled by the thought of weight gain...I would love to not take 8 shots a day and feel like I am feeding my lows (gaining weight) but I have also heard that switching to a pump causes weight gain which I am PARANOID of!!!!  Anybody else notice the weight gain from the switch?  I have been on MDI for about 19 years.  I tried the pump like ten years ago and got off it.

If you don't want the "tube yoga"  go for the Omnipod.  No tubing.  Just stick it somewhere and you are done. 

She likes picking out different color pumps and stuff but I think its the being attached and having that "thing" in her tummy that bugs her. She says maybe when she is older she it wont bug her. She again today has been giving herself most of her injections in her belly so that is a step forward. I am just sick of seeing 400's on her tester even when giving her the right amount of insulin and splitting it up and giving her extra 2 hours later and still a hour after that it being a higher 400 reading than the first one. Blah! Tomorrow we go get them registered at a clinic here then hopefully into a endo.