 I'm
Pumping
Why I decided
to go on the pump
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 Hi,
my name is Nutan and I have been a Diabetic for over
21 years. I am married with two young children. I have been
on the MiniMed Insulin Pump for around three months now.
Let me give you a brief background as to why I made the decision to go on the pump. I was on four daily injections. I found that I was waking up with really high blood sugars in the mornings, and was always frustrated by this. I had tried to adjust my night protaphane doses, without any good results in the mornings. The one thing that I did notice was that when I had a really late night and took the protaphane much later than the normal time I would get really good readings. So my protaphane was running out before I got up in the morning. I was not prepared to go to bed at 1.00am every night. Seems like a really vicious cycle doesn't it? (This is known as the dawn phenomenon.) |
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| I had been on the internet chatting with other Diabetics
in the US, and I found out about the pump
as they kept on telling me how good it was. I investigated the pump on the internet and found out that there is a supplier in Sydney. I received an information pack from them. It contained all that you need to know initially to get you seriously thinking about it (including a video). What really sold me on the pump was the fact that you only change the infusion site every 2 - 3 days, the freedom that you have with it is unreal. You may think that you are hooked up to a machine, but it is only the size of a small pager and is very lightweight and you get used to it really quickly. You also reduce the amount of insulin required on the pump, that is because it is delivered over a 24 hour period with a basal rate using approximately half of the daily requirement and the mealtime boluses using the other half. The pump only uses quick acting insulins, actrapid or humalog. The beauty of “pump therapy” is that you can miss a meal if you are not up to eating, without going low or high by easily adjusting your basal rates at any time. You can also eat more of what you want to eat and less of what you don't want, as long as you adjust the insulin doses carefully. And finally I can go to bed when I want to, too. You really need to keep a very close check on what your blood sugars are doing with the pump, as the chances of developing Diabetic Ketoacidosis increase because you don’t have any insulin in reserve in your body, so I have been told. It takes a bit of experimenting but it basically allows you a lot more flexibility. The pump can also be turned off at any time too: you just put it into suspend mode and it automatically switches off. You can safely have it off for up to 1 hour. It is very easy to disconnect the pump for a shower (or other activities, if you get what I mean ?). You do need to be very careful with hygiene as skin infections can occur (I personally haven't experienced any). The pump is also equipped with many alarms and will warn you if anything is wrong with it. It is very simple to use and what's more, it doesn't hurt when you put the cannula in. I have been really happy with it and recommend it to anyone who thinks that it may be good for them. My blood sugars have been good most of the time, and I generally feel a lot better in myself too. I feel that I have more energy. It's a really good topic of conversation, too. If I can help with any questions that you may have about the pump or
life in general, please feel free to email me: rovearnd@netspace.net.au
. I would love to hear from you.
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Why take the plunge? 
After reading all the info from MiniMed, I consider myself to be the perfect candidate. I am in fairly poor control, I have high HbA1c levels and I have a very hectic lifestyle. (I am a chef and I work an average of 55 - 65 hours a week) - Cath After having been IDDM for 20 years now, I have had it with injections jamming, the needles bending, the lumps, bumps and bruises. I have heard from many people in the States that pumps are great for pregnancy, and for better control over long periods of time, therefore reducing the risks of complications later on. - Leanne Bone A cool thing about the pump is that you can change your basal rate for
exercise or stress ... like I just went running and if I had been on regular
injections I would have had to eat a bunch of glucose tabs or juice or
something, which was my old method, but now I just make a temporary basal
rate of half as much as usual so I don't over-insulinize myself and go
low and have to eat. - Katrine Wilson
Insulin Pumps - Pros & Cons
by Matt Cohen, Director Medical Services, International Diabetes Institute, Melbourne In the never-ending quest to achieve better blood glucose control (without causing more hypoglycemia) some people with Type 1 have turned to insulin pumps. Some diabetes specialists, especially in the US, are enthusiastic about them, and they were successfully used in the Diabetes Control and Complication Trial (DCCT) from 1983 - 1993. My interest in pumps began in 1978 when I was a registrar at the Royal Melbourne Hospital, where I used some early models on inpatients. In 1980, at what is now the International Diabetes Institute in Caulfield, my colleague Professor Paul Zimmet arranged to bring in some insulin pumps from Japan. They were much smaller than earlier models, about the size of a hand, and cost about $750. Over the subsequent 2 years, I taught 8 patients (whose diabetes was very difficult to control) how to use insulin pumps. There was even a news item on national TV. Although the pumps worked well and improved their control, we had a few problems with blockages at the needle tip, and some infections where the needle was situated. Half the patients, (those under 30 years old) did not wish to continue, generally because of concerns about body image. The older half continued for up to 2 years. All achieved good HbA1c levels without significant problems with hypoglycemia. Around 1983, insulin pens were introduced, and it became much more convenient to give 4 injections a day. All but 1 patient preferred to use a pen rather than the pump, and currently I have no-one using pumps. Over the years I have seen many insulin pump companies come and go, and now only 2 - 3 remain. I keep up to date with the new pumps (which have many additional features and are very small) and have spoken to the few physicians interstate and overseas whose patients use them. I believe only 2 or 3 doctors in Australia (in Perth and Sydney) have a total of about 30 patients currently on pumps. From time to time I receive enquiries from patients, but to date, no one has been willing to "take the plunge" even though I am prepared to offer my expertise and support. One issue is that doctors and educators need to send a lot of time initially, and be "on-call" 24 hours a day in case of problems. Without experience in pump therapy, few doctors are willing to suggest it. The advantages of the pump are the level of control that can be achieved, particularly when used with the new fast-acting lispro insulin (Humalog), and the convenience of not having to draw up or inject insulin. The ability to pre-program changes in the overnight (basal) rate is sometimes the only way to achieve good control throughout the night. The disadvantages are:
I would certainly encourage anyone who is interested to look into it further. There are 2 pumps available in Australia, Minimed and Disetronic, and both are excellent. Their websites http://www.minimed.com and http://www.disetronic.com have lots of useful information, as do the manufacturers' representatives. An Endocrinologist's View
by Dr Neale Cohen As an endocrinologist, I have very limited experience with insulin infusion pumps as do most people in Australia. Currently I have 3 patients using the MiniMed system, and all are quite satisfied with results so far. The modern pumps consist of small computers containing a reservoir of rapid acting insulin. Insulin is delivered as a continuous infusion via plastic tubing and a needle which the patient must insert under the skin. This needle site needs to be changed every 3 days and this is not technically difficult. These computers cannot measure or monitor blood glucose levels. Furthermore the pumps will only deliver the insulin that is pre-programmed and patients need to add supplemental doses of insulin (via a bolus button on the computer) with meals and snacks. My impression so far is that these devices work very well with few, if any, complications. There are occasional tubing problems but these seem infrequent and easily fixed. The main problem is cost, and at about $5,000 per pump plus the cost of the tubing, one would need a good reason to throw away your insulin syringes or pens. It is worth pointing out that private health insurance may fully cover the cost of the pump. I think there are many benefits to patients who are prepared to monitor blood glucose levels frequently (more than 4 times a day). With a constant infusion of insulin, one is able to vary eating times and become much less of a slave to the rigid dietary requirements of insulin dependent diabetes. This has significant lifestyle benefits. There is also a benefit in terms of diabetes control. The continuous nature of the insulin infusion tends to improve diabetes control. I have found this useful in patients with frequent, severe hypoglycaemia, particularly when there is hypoglycaemia unawareness which may result in collapse or coma. Again I would only recommend this system in the highly motivated patient who has tried various regimes without success. Overall, I am impressed with this piece of technology which has been designed mainly to improve the lifestyle of people with insulin dependent diabetes and it does have benefits in terms of improving diabetic control. Another happy pumper ….
from Mike Leeds G'day, You probably don't remember me, I wrote a couple of months ago (January seems like only a couple of months ago), asking about the pump. My diabetes was literally out of control, but after a trial of 3 months, I've decided to use it on a permanent basis. It's been brilliant!!! Just writing to say thanks for all the contacts and help, and love your work, it makes a huge difference! Pleeeease let everyone know about how good the pump is, I'm happy to talk to anyone looking at getting a better quality of life. People don't know enough about the pump. I'm spuuuin' I can't come to ISYAD, but look forward to coming to see
it all happen one day!
Mike Leeds < mleeds@hotmail.com >
More info
Phone 02 8448 2043, Fax 02 8448 2054, email minimed@executivecentres.com.au
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Basal
- the tiny amount of insulin continuously delivered by the pump