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    Insulin pumps
    Dennis0235 posted:
    Hi! I have been diabetic since 2001. At first I was diagnosed with Type 2 and since July 2012 I have been treated as a Type 1. My best A1c was a 10 about 3 years ago. I am just wondering how hard is it to be put on the insulin pump. I will be discussing this with my dosctor next week and just wanted to have any questions and he might ask ready to go. I am tired of being out of control and have a hard time taking oral medications and insulin. The pump seems like a better solution and reminder to take my medications. Any help would be greatly appreciated.
    mrscora01 responded:
    A pump can certainly help, but it is a lot of work. It involves fasting periodically at various times of day and testing your basal rates (most pumps allow up to 18 different basal rates which helps with varying insulin sensitivity and dawn phenomenon). It also means a ton of testing to check your insulin to carb ratios (can also be different at different times of day). Do you carb count well? If you don't, a pump won't be much help.

    As I said, a pump is a ton of work. But I found it well worth it as it allows a lot of flexibility and benefits such as:

    -one shot every 3 days rather than 4 - 5 per day
    -combating dp
    -having seconds and bolusing with the touch of a button
    -decreasing basals for exercise
    -sleeping in/staying out late without worrying about lantus shots
    -micro dosing

    Feel free to ask any questions. I pumped for 5 years before my transplant.

    T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
    jcarrigan2 responded:
    A pump can be very beneficial in your situation. I also had trouble controlling my blood sugars they were out of control. For several years my A1c was always in the 12 to 13 range. It took me working with my primary care doctor and endocrinologist about 2 years before I could get them to work with me to get the pump. They wanted me to try all different approaches before they agreed. Once they agree the next big step will be your insurance company to see what and how much they will cover.
    I have been on a tubeless pump for about 5 years and it does take some work. When they put me on the pump they also recommended I go on a 24 hour glucose monitoring system to use in conjunction with the pump. The combination of the two has helped me. Because of the way my body handles the insulin I still take oral meds and use a long acting insulin to work with the pump.
    The nice thing about the pump is that it provide insulin on a programed interval 24 hours a day and when you need more you just calculate and program what you need. the glucose monitoring system is a wonderful tool also, it takes a reading every 5 minutes and sends the information to the monitor so you can read your glucose at any time, you can also program it to provide warnings for when your levels get to high or to low.
    Mimi4and4 responded:
    I have had my pump for 5 years. At the beginning my A1c's were running 9-11...NOT GOOD! Now they are usually in the 5.5-6.5 range. The pump is not a magic fix. It is a commitment . I check my sugar before and after every meal and at bedtime. BUT...because of this I am much more aware of what I am eating and it's effect on my sugar. So I am eating better and have lost weight too. So, I recommend it as a TOOL to help you get and keep your diabetes under control. It is NOT a way to eat poorly and just give yourself more insulin to cover it. Just sayin...
    Mimi4and4 replied to mrscora01's response:
    Your diabetes educator can help with all these pump settings. I have never had to fast to check my basal setting. Maybe you are very brittle and so need to do all this extra work. I got stable right away so don't have to change settings often. And "having seconds and bolusing with the touch of a button..." Is not what it is about anyway. That is away to gain weight in my opinion.
    Anon_838 replied to Mimi4and4's response:
    Since there are several insulin pumps to choose from I would suggest checking with your insurance company to see which pump they will cover. That way you can narrow down your choices and do some research on which one will better suit your needs. Keep in mind they all have different features. Here's a few names to Google. Animas, MiniMed, T-Slim, Omni Pod, etc.

    Your doctor will need to write a "letter of medical necessity" for your insurance to cover it. You will also need to meet a certain criteria. I highly recommend that you let the pump company you choose to do all of the paper work to send to your insurance company for approval.

    You can also get the Rep's to come meet you at home or anywhere you choose to give you a demo on how it works before you commit to something you're unsure of. They want your business and will fight to get it so, call them.

    Good luck! I'll be happy to answer any questions you may have. I'm currently using the MiniMed523 and CGM. Pumping for 7 years.
    Denny1947 responded:
    1989 is my date I have gone from oral meds to insulin plus oral meds I am a brittle diabetic I use a medtronic pump works but can be a pain sometimes Tried using glucose monitor inserted under skin not worth the money that sent results to the meter about drove me crazy! Basal rate is a total of 72 units per day Bogus 10 to 15 units 3 to 4 times a day Last A1C 10 Carbs under 100 per day Pumps help but the thing that helps the most is the basal rate and diet. Normal people may use 35 units a day to deal with glucose swings so as you can see I am not normal. Pumps are very expensive depending on you insurance Once you get one you have to buy the reservoir and quick set cannulas from that company
    mrscora01 replied to Mimi4and4's response:
    Mimi, I had excellent a1cs with my pump. I did not gain weight because I did not abuse it or fall into the urban legend of "you can eat whatever you want". I occasionally had seconds and that is simply one of the "treats" of pumping. Not needing that second shot at a meal.

    As for fasting, it is a quick, easy, and accurate way of checking if your basals are correct. I did it once or twice per year. No big deal missing one meal during the day. It is quite common to do this in our "industry". If you are able to get good basal rates without fasting, good for you. But it doesn't work for everyone and isn't always that accurate a way to do it.

    And why do you think I needed help with my pump settings? I always had excellent a1cs and adjusted them myself. And besides, I don't pump any more. I've had a pancreas transplant.

    T1 1966, Dialysis 2001, kidney transplant and pump 2002, pancreas transplant 2008
    Terriejean responded:
    Hello Dennis, I have been using a pump for about 7 years with good success as long as I don't abuse it and bonus to eat anything I want! I tried the continuous monitoring system but found it very hard to insert properly and it also was scarring up my stomach leaving little room for my pump insertions so I stopped using that system. The pump works well, I have a problem with low blood sugars as well as highs so I test about 8/10 times a day. It is easy to adjust basal rates yourself but until you are comfortable with the pump and blood sugars it is advisable to refer to a diabetic specialist. I did not fast at first and only fast once in a great while which does help me keep current with Basel rates. My A1Cs are in the mid 6s. The biggest thing that I do not like at this time is the fact that the pump is your best and worst friend as you have to wear it 24/7! You can't get away from it! All in all it is much better than doing shots several times a day and control is better. I use a Medtronic Paradigm and I have been very happy with their support! Good luck and God Bless!

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