Adjusting to an Insulin Pump


This site is not intended to advise you on any changes to your diabetes treatment plan.  Consult your physician before making any changes to your diabetes treatment!  This page is simply published to give my personal experience switching to insulin pump treatment for my diabetes.  It is intended to help those who are unsure of whether or not an insulin pump would be a good treatment for their diabetes.  
Helpful Links Pics of My Pump Reports of Days 1-4 on Pump HBA1c's My Random Thoughts & Comments


So maybe you're thinking about going on an insulin pump but all you find online is a bunch of websites that tell you WHY you should go on a pump.  They tell you about how pumps work, and why it is important to maintain good blood-sugar control.  Well, obviously everyone wants to control their diabetes better, but it depends on what it takes to achieve that better control.  This page is aimed to help the person who actually wants to know what it's like to wear a pump and how much time and energy is required to wear a pump.

Helpful Links

  1. Useful Statistics compiled from pump users.
  2. Pump company websites: Minimed,Disetronic, Animas, Deltec, Dana.
  3. History of Insulin Pumps -very interesting pictorial of how insulin pumps have evolved.  This page should give you some appreciation of the technology that is available today.
  4. Bob's Corner of the Web -interesting personal website from a pump user.
  5. Bludasue -another interesting personal website.
  6. Insulin-pumpers.org -everything you need to find about pumps.
  7. Fine-tuning your pump - provides detailed instructions and forms to help you determine your basal rate(s), Insulin-to-Carb ratio, correction factor, et cetera.  Very useful, well constructed site.
Before you can wear a pump you must choose one.  I choose the Paradigm 511 by Medtronic Minimed.  I choose this pump mainly because of the popularity of Minimed's pumps (so many people probably aren't wrong) and because of its small size.      

Cannula without the needle, as it would sit in body.
Pump next to quarters.  The pump can easily fit under a shirt or in a pant pocket.
The cannula with the needle still in it.  The 9mm cannula is a little smaller than the 1/2" 29guage insulin syringe.



Front view of leather cover that can be worn on a belt or pants.
View of cover opened.
Back view of cover with belt clip.


After choosing the Paradigm, it took about two weeks to get everything together and processed and have the Paradigm arrive in the mail. Learning to use the pump was a breeze.

I began using the pump on July 14th.  I had to wear the pump for a week on saline instead of insulin in case I ran into any problems.  

Day One


On July 21st., I began using the pump with insulin.  I began on a basal rate of 1.5 units/hour and an insulin to carb ratio of 1 unit to every 7grams of carbohydrate.  I had to skip my usual injection of Lantus the night before which concerned me because I didn't want to wake up with some astronomical blood-sugar.  I woke up and my blood sugar was 144; pretty surprising.  Here is a chart of my first day on the pump:

Date: 7/21/03









Time:
9am
11am
12pm
2pm
5:15pm
7:15pm
11:30pm
12:50am
1:15am
3:20am
3:40am
BG:
251
171
130
68
69
81
76
81
120
66
91
Carbs:


135g
30g
111g






ICR:


1u:7g
19.5units

1u:7g
15units






Insulin Correction:


.3u








Basal Rate:
1.5u/hr






1.0u/hr



Comments:  Lunch was 3.5 slices of pizza.  Dinner was chicken pie with a roll.

One can see that there was a lot of testing the first day and that adjustments need to be made to both the basal rate (as indicated by the mid-night lows) and the bolus rate (as indicated by the post-meal lows).

Day Two


Date: 7/22/03









Time:
9am
11:15am
12pm

3:15pm



1:00am
3:20am

BG:
234 129 82
59


227 168
Carbs:


100g

30g






ICR:


1u:8g
11.5units








Insulin Correction:
4units







1unit


Basal Rate:
1.5u/hr



1.5u/hr



.8u/hr
1.0u/hr

Comments:  Lunch was some hot dogs and beans.  Dinner was some McD's but I was with a bunch of people and didn't didn't want to test.  Drank some beers and went to the Bon Jovi concert at night.  Put my basal rate down to .5u/hr while I was drinking so I didn't run into any hypo problems.  Probably not something I want to make a habit of though.

Day Three + Four


Date: 7/23/03-7/24/03









Time:



2:20pm
4:00pm
5:45pm

7:00pm
12:00am
3:30am
8:00am
12:00pm
BG


57
57
84
93
117
89
123
105
Carbs:



15g
30g

50g

7g

105
ICR:






1:8



1:9
Insulin Correction:











Basal Rate:



1.2u/hr
Switched to 1.0u/hr


Switched to .9 u/hr

Continuing .9u/hr

Comments:  Things started to smooth out a little with the basal rate switched down to .9 units per hour.  Dinner at 7:00pm was a cup of rice with a breaded chicken breast and a beer.  Lunch at 12:00pm was a steak and cheese sub with some soda.

HBA1c Test Results

Met with my Dr. yesterday for my pump follow-up visit.  On June 10th, my HBA1c was 7.1 (153) with my previous treatment using Lantus and Novopen treatment.  After being on the pump for almost a month, my HBA1c went down to 5.5 (105).  This was a huge surprise for me.  It was kind of like a reward for the work or effort I had put towards my new pump. 

Date
Test Result
6-10-03
7.1 (153)
8-14-03
5.5 (105)



My Thoughts and Comments Regarding Pump Therapy

  • Physically, wearing the pump has been pretty much trouble-free.  It is so small and light that you rarely notice it's with you.  I find the infusion sites are completely pain free.  The plastic tubing can be a pain to hide sometimes.  I usually tuck it into my pants or boxers. 

  • I've come to realize I need to take a more active role in my diabetes management.  Before the pump, I would not take supplemental insulin if my BG was over 200 because I didn't want inject the needle.  Now, I can just hit a few buttons and get a very precise bolus.  This allows me to control my glucose much better, not only because I'm willing to take an extra little bolus, but because I test more knowing I can make these small corrections. 

  • My only negative experience thus far with the pump was waking up one morning and testing my glucose to find a surprising 400.  I tested moderate for keytones.  I realized that the tape around the cannula had become caught on my bed sheet during the night and pulled out.  The tape had started to peel off the day before and that's what caused the problem.  I took a 12 unit bolus and came down fine.  What I learned is that I need to change the cannula every 2-3 days and not try to get a few extra days out of the infusion set and site.  The 12 unit bolus came two hours before my job interview that I had scheduled that morning.  Diabetes was the last thing that I wanted to worry about during my interviews.  Fortunately everything worked out fine, but I learned exactly how fast my sugar can rise without my basal insulin being delivered and what I can do to prevent it in the future.

  • It has been about six months since I began using my insulin pump. Since the last time I have posted a comment I have had only positive experiences with my pump; with the exception of one more time the cannula came out while I was sleeping.  I believe it happened right before I woke up.  When I awoke and noticed the cannula had come out of my abdomen,  I quickly got up to check my blood sugar which was around 218.  I don't think the cannula was out for too long because the low-200 reading had been the norm for my morning blood sugars.  I changed the infusion set and took the usual morning bolus to bring myself down to normal.  So far things have been working out well.  The next test I need to do is my nighttime basal rate.  I've been too lazy to wake up every two hours during the night to check it.  The pump is so easy to use and dependable that I have found myself becoming more lazy and giving my diabetes less attention than I probably could benefit from.  I think part of this is because I still get better control than I previously had maintained with much less work.  I guess this is a good and a bad thing.  The pump can move your care closer to perfection but can also allow you to become complacent because of its consistency.