Switching from MDI to insulin pump therapy brought up a lot of questions for me, as a patient with type 1 diabetes. I had a few hang-ups about moving from injections to wearing a device. I wanted to know what made pumping a stronger option for me than injections. And what if I hated wearing a device? Or what if my insurance company refused to cover it?
My endocrinologist at the time was at the Joslin Clinic in Boston, and she had a bunch of patients who were using insulin pumps. I expressed some of my concerns to her (kind of all-in-one mashed up sentence):
“What makes pumping better and is it expensive and what if I go through all the hoops and then end up hating the thing?” She let me take a breath, and then she grinned, as if she had been waiting for me to ask these questions.
She spread out a bunch of brochures on her desk and we went through the different insulin pumps on the market at the time. She talked with me about my issues with morning high BGs (dawn phenomenon) and how adjustable basal rates could help, as well as help with my overnight lows.
Beyond that, my endo also discussed some ways that life would become more flexible using a pump – it would be hard to forget to take insulin when I’m wearing it 24/7, it would make exercising easier (lowering basal rate beforehand, etc.), it would be easier to bolus for meals and corrections without whipping out another syringe, and overall, it just made diabetes less intrusive. I had to remind myself that diabetes was unchangeable, but I had options as to how I delivered my insulin.
She gave me a list of the different insulin pumps available on the market at the time, and then I went home to make my own list of pros and cons to determine what might work best for me. There were a lot of factors that mattered to me, but size mattered the most. I wanted the smallest pump available. Back in 2004 insurance providers weren’t readily approving insulin pumps and patients had to build a case for needing one. My insurance company helped me gather the info I needed, my doc wrote a prescription, and the order was placed.
A few weeks later, the delivery service showed up with a big box of insulin pump supplies and my first insulin pump. It was a big moment, like a Christmas just for my diabetes. After 17 years of injections and reaching a total of 7-9 syringes per day, I was so ready for this change.
“So you’ll put the pump on with saline in it first, to get a feel for pushing the buttons and inserting the infusion sets,” my endo said, after my insulin pump had been delivered.
“Okay, so I wear the pump and also still take my injections? I’ll do both?”
“Yes. Then you’ll come back in and we’ll start you on insulin.”
Those three days were a pain, but they were admittedly very useful in determining the pump’s true wearability, durability, and integration into my actual life. The saline trial time gave me a chance to ready and steady my hands to insert an infusion set. (Back in 2004, I was manually inserting sets, which both empowered me and mildly grossed me out.) It also let me test-run what it was like to get dressed with the pump as my new accessory.
When I went back to get hooked up on insulin, my endo was excited for me. “This is a big change, and one that I know will help you accomplish what you’re aiming for,” she said, handing me the sheet with my new basal rates and insulin-to-carb ratios on it. “You’ll do great.”
Today, after over ten years of pumping insulin, I know it was the right choice. Pumping insulin helped reduce the intrusions diabetes made in my life. It’s also what helped me bring my A1C into a healthy, safe-for-baby range when I started thinking about having a family. Now, when I see my daughter reach over to tickle her baby brother, I’m grateful for the little metal pancreas I wear on my hip that helped ensure my health and their safe arrival.
Kerri is a passionate advocate for all-things diabetes. She is the creator and author of Six Until Me, one of the first and most widely-read diabetes patient blogs, reaching a global audience of patients and caregivers. Her first book, Balancing Diabetes (Spry Publishing), looks at type 1 diabetes in the context of “real life.” Kerri has lived with diabetes for 30 years. She has experienced a full childhood, the teen years, the college experience, and now pregnancy and parenting, with diabetes along for the ride.