"Rebecca was diagnosed with type I diabetes 20 years ago when she was 12 years old.  She had to give herself at least 4 injections every day.  On top of that, she had to prick her finger to test her blood sugar many times every day.  She had to decide how much food she was going to eat before she ate it, and then she was not allowed to eat any more food until her next injection." Okay, I know that sounds a bit dramatic, but if there were a television show about diabetics going on pumps and I was on it, that is how I imagine mine would start.

I used Humalog in a pen before meals and I used NPH in a syringe at bedtime.  I used a syringe at bedtime because I usually had to mix in some Humalog to correct a high or to cover a small snack.

Resisting the Pump

I never wanted a pump.  Ten years ago a good friend of mine in college kept telling me how much he loved his pump.  I didn't even want to know about it.  Over the years, various friends, acquaintances, and doctors have told me I would really like the pump.  I didn't think so.  First and foremost, I didn't want to be attached to anything.  I also didn't want to devote a lot of time to learning anything new because that would mean that I would have to spend more time facing the fact that I had diabetes.  I also didn't want to sleep with the pump, shower with the pump, or work out with the pump.

Then a lot of things changed in my life when I became pregnant with my daughter.  I started to focus on my diabetes so that I could have the best control possible and I started reading the Diabetic Mommy forum.  I read so many messages from women who loved their pumps.  Still I thought, "Nope, it's not for me."  Then one day after I'd been reading these messages for well over a year, a woman named Fantacy posted a funny remark that she loved her pump so much, she wanted to be buried with it.  Something finally clicked in my head.  Maybe I should at least consider it. 

Caving to the Pump

I asked my endocrinologist about it at my next appointment.  He said that I could take a class at the nearby Diabetes Treatment Center to find out if the pump was right for me.  I decided to do it because I had nothing to lose.  I wasn't committing to anything.  So I went to the half-day class and learned about pumping and carb counting.  I was glad that I was already familiar with carb counting because the class moved pretty fast. 

This is the pump I chose, the Animas IR1200.  This picture makes it appear larger than it really is.  It is about the size of my middle three fingers.

After the class, the next step was to select a pump that I wanted to test drive.  We were given a choice between the Animas IR1200, the Deltec Cozmo, and the MiniMed Paradigm.  I had seen the pumps in class and I also researched them extensively on the web.  I decided which features were important to me and compared the pumps on those features.  After narrowing it down to the Animas IR1200 and the Deltec Cozmo, I eventually decided that the Animas IR1200 was the best pump for me.

I scheduled an appointment with a certified pump trainer at the Diabetes Treatment Center for my pump test drive.  At my appointment, she showed me how to use the Animas pump, an insulin cartridge, and an infusion set.  We filled an insulin cartridge with sterile saline solution instead of insulin so that I could experiment with the pump as much as I wanted and not affect my blood sugars.  Then we inserted an infusion set and hooked it all up.  I was allowed to take it home with me for 2-3 days to wear it and use it as if I were really pumping. 

Wanting the Pump!

Less than 24 hours later, after my first night, workout, and shower, I called my doctor's office and told them that I wanted the pump!  I didn't mind being attached to it too much.  I could easily disconnect it for short periods of time (up to an hour), leaving only a little plastic disc attached to me.  I didn't notice it while I slept, the infusion set didn't budge during my workout, and after my shower I felt completely clean, even under and around the infusion set. 

This the infusion set. 
This is the only part that is ever attached to my body. 
I completely remove it and replace it every few days.

The infusion set disconnects easily. 
The metal piece does not go under my skin at all,
but only into the plastic disc.

The plastic tube is the part that goes under my skin. 
It is  flexible and I cannot feel it.

It took 6 weeks for me to receive my pump.  When I got it, I immediately took it out of the box and starting playing with it.  One week later I went to my endocrinologist's office and met with a certified pump trainer to start pumping with real insulin.  We programmed the pump with my settings and then filled an insulin cartridge, inserted an infusion set, hooked it all up and started pumping!  I took my blood sugar and bolused for the high reading.  We went for a walk to kill some time while my blood sugar came down.  Then she brought some of the doctors' catered food to me for lunch.  I checked my blood sugar, counted the carbs, bolused appropriately, and ate.  Everything seemed to be working well, so I was okayed to go home and begin pumping on my own.

The pump just allows me to stick myself less, right?

Before I started learning more about pumps, I thought that the main advantage of pumping over MDI (multiple daily injections) was having to stick myself only once every few days rather than multiple times a day.  But in reality, it is so much more than that. 

In order to understand the advantages of pumping over MDI, let me first explain a little bit about how a normal pancreas works and how MDI and a pump each attempt to mimic a normal pancreas.  A normal pancreas releases a very small amount of insulin every few minutes.  This is called basal insulin.  Then when food is eaten, a normal pancreas releases a large burst of insulin.  This is called bolus insulin.  With MDI, bolus insulin needs are met with an injection of fast-acting insulin such as Humalog or Novolog.  Basal insulin needs are met with an injection of long-acting insulin such as NPH or Lantus.  Long-acting insulins affect blood sugars slowly over time, in an effort to mimic the way a slow drip of insulin from a normal pancreas affects blood sugars slowly over time.  The pump is able to mimic a normal pancreas by doing exactly what a normal pancreas does.  It uses only fast-acting insulin.  Basal insulin needs are met by releasing a very small amount of insulin every few minutes.  Bolus insulin needs are met by releasing a large burst of insulin. 

When I was taking NPH, I just had to hope that the insulin and my body's need for insulin peaked at the same time and by the same amount.  But with a pump, I can adjust my basal rate to peak exactly at the same time and by the same amount that my body's need for insulin peaks.  It is like taking a long-acting insulin that is tailor-made for my body.

Since I don't have to take a long-acting insulin, there is alot less guess work about how insulin is affecting my blood sugar at any given moment.  It is much simpler.  I take a short-acting insulin, it peaks after about 1 hour, and it is out of my system after about 4 hours.  When I was taking NPH, I never figured out exactly when it peaked or how much was still in my system at any given time.  It just added so much complexity to an already complex situation.  Since discontinuing NPH, I have learned many things about my blood sugars that I never knew before.  For example, I never knew that protein raised my blood sugar significantly about 3 to 5 hours after eating.  Now I know that.

When I was on MDI, I often realized a few hours after eating that I had taken too much insulin and I was starting to go low.  Imagine my being able to go back in time a few hours and take less insulin.  Effectively, with a pump, I can do that!  I just turn off my basal insulin for a while.  I never could have "turned off" my NPH for a while!  Now instead of going low, my blood sugar remains steady or even goes up a bit.  Of course this doesn't work if I have taken far too much insulin, but it works in many cases.

Protein affects my blood sugar significantly, but over a longer period of time than carbs.  With the pump, I can use an extended bolus to deliver insulin over many hours as the protein digests.  With MDI I just had to correct my high after the fact because I did not have the capability to deliver the insulin over many hours.

Correcting a high is so easy that I correct any and all highs, even if I am only 10 mg/dl over my target.  It is easy for two reasons.  One, because I only have to push a few buttons instead of taking another injection.  And two, because with MDI, my pens and syringes only allowed me to give myself insulin in whole unit increments, so correcting a blood sugar that was 10 mg/dl over my target would have sent me low.  With the pump, I can give myself insulin in 1/20 unit increments and correct a high nearly perfectly.

I need less insulin on the pump.  On MDI I took about 50 units per day.  Now I average about 35 units per day.  It amazes me.  I still take almost exactly the same amount of basal insulin, but my insulin to carb ratios have gone way up, so my boluses have gone way down.  On MDI, my insulin to carb ratios were 1:14 at breakfast, 1:10 at lunch, 1:7 at dinner, and 1:7 at night.  Now they are 1:24 at breakfast, 1:14 at lunch, 1:14 at dinner, and 1:16 at night.  On MDI, I would often bolus as many as 16 units at a time.  Now I get nervous bolusing anything over 6 units at a time! 

One of my favorite features of the pump is the IOB (insulin on board) feature.  A given amount of insulin, whether delivered by injection or pump, does not get used by the body all at once.  For example, it takes about 4 hours for Humalog to finish working from the time it is injected/infused.  The pump keeps track of how much insulin I have bolused and how much insulin is yet to be used by my body.  Before I went on the pump, I took IOB into account, but only in a very crude and inexact way.  Now it keeps me from over-correcting both highs and lows.  It keeps me from over-correcting highs because if I take my blood sugar 1-2 hours after a meal, I'm tempted to take enough insulin to get my blood sugar down to my target range.  But now I'm finding that often I have already taken enough insulin, I just need to give it some more time to work.  It keeps me from over-correcting lows because I used to eat and eat because I didn't know how fast or how far low I was going.  Now I can check my IOB and fairly accurately figure out how long I should suspend my pump and how many carbs I need to eat, if any.

This is me wearing my pump. If you look closely, you can see the tubing running into my pocket. If I don't want the tubing to show, there are other ways I can wear my pump.

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This is not a health care site. The editor is not a health care professional, is not qualified, and does not give medical or mental health advice.

Please consult with qualified professionals in order to find the right regimen and treatment for you. Do not make changes without consulting your health care team. .

Because this site is for all diabetics at all stages of life, some information may not be appropriate for you - remember information may be different for type 1, type 2, type 1.5, and gestational diabetics.

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