By: Tom Kacy

Tom Kacy — Sat, 16 Jun 2007 15:49:17 +0000

Jeff,
I have only been pumping for a little more than three months, so obviously
I have only used one pump - a Minimed Paradigm 715. The 715 (and 515 -
same pump, slightly smaller and holds less insulin) is MiniMed’s newest
model and has made life with diabetes easier for me.
1. No long-acting insulin in my body. This means that I’m not caught by
surprise in the middle of the afternoon, early morning or any other time of
day by my long-acting insulin kicking in like crazy. I found that even
Lantus had a peak, and I could not predict if/when it would decide to come
on strong.
1A. Many (most) of my severe hypos were caused by long acting insulin. For
the lows where I did NOT become unconscious and was able to treat myself,
it could take a couple of hours before I’d be in a normal range. This is
especially true of NPH. I’d drink a juice box, check in 20-30 minutes and
still be low, sometimes even lower than before the juice. Drink more

juice, wait, test. Sometimes I’d go through several juice boxes and other
food before my vision & mind would clear. Many times I’d end up going too
high an hour or two after that. Now, since I only have Humalog in my body,
lows are easily treated. One juice box or less takes care of it. No
over-treating the low, no rebound high readings later.
2. Different basal rates. Hands down, this might be the best feature of
the pump. Instead of injecting a full days worth of long acting insulin at
once, you spread it out as you need it. With Lantus or NPH, if you need
the insulin working harder in the morning but working very little during
the afternoon, you’re out of luck. That insulin will work however it
wants and may or may not decide to drop your BG suddenly, or take too long
to work and cause you to go high at certain times.
3. My pump, and I assume the other newer pumps, will calculate how much
insulin is still working after a bolus. This also helps to avoid
lows. Before, I would inject & eat. An hour later I might decide to eat
something else, so I’d inject more. Or, I might have a high reading &
inject Humalog to correct it. An hour later if I was still high, I’d
inject again. All of those injections would overlap and I’d end up with a
bad low a couple of hours later. Now, if I go to a party and want to graze
on food all day, my pump will let me know how much insulin is still at work.
4. This goes along with #2 - the pump does the math for me. Now, the pump
can only work with the information you give it, so you will need to know
some important things before you can use the pump successfully. You need
to know your Insulin:Carb ratio (or ratios); how long the insulin lasts in
your body; and how much your blood sugar will drop from one unit of
insulin. Once you know those numbers and program them into the pump, it’s
very easy to get the correct doses. Even on injections, those are numbers
that everyone should know. I never did, and would always guess when it
came to injecting before a meal. Sometimes it worked, especially if it was
something I ate all the time.
5. The pump is convenient. Many times I would leave work to run some
errands, and wouldn’t take any of my diabetes gear with me. Once in awhile
I’d pass an ice cream truck and at the time, I would have killed to have
some. Since I didn’t have an insulin pen with me, I had to pass. Now, if
I decide I want something on the spur of the moment I can, as long as I can
figure out the carbs of course!
6. It’s much, much easier to cover a high fat or high protein
meal. Instead of having to inject all at once, or making multiple
injections to eat something like pizza, I can tell the pump to give me some
insulin now and the rest spread out over a few hours. That way I’m not hit
with all of the insulin before the meal has digested. The insulin can work
slowly, like the food.
7. I can’t forget an injection. Many, many times I’d be eating and then
realize I hadn’t taken my insulin. Sometimes I WOULD have taken the
insulin, but I was convinced I hadn’t. I’d end up injecting double and
have a nice hypo later. The worst was forgetting to take long acting
insulin at night, and waking up sky high in the morning. With the pump, if
I’m not sure my meal is covered I can just look at the screen and it will
show me when I gave myself a bolus.
8. Someone mentioned gaining weight on the pump. The pump has allowed me
to lose weight. I’m not constantly feeding the lows, or eating extra carbs
because I’m more active. I’ve been able to skip meals without a
problem. If I’m going to be extra active, I can lower my basal rate or
stop it completely for awhile.
I do not mind being attached to the pump. It stays out of sight and the
tubing is hidden under clothes. Pretty much all infusion sets have a quick
disconnect, so you can remove the pump & tubing while leaving the infusion
set in place. I disconnect when I take a shower, then reconnect once I’m
dressed.
Right now, I really can’t think of any negatives about my pump. I’ve got
insurance so my pump & supplies are covered, but if I had to pay for
everything that would be a big negative. Pumping IS expensive if you don’t
have insurance. It can be pricey even if you do have insurance, depending
on their co-pays and whether they cover it as diabetes supplies or durable
medical equipment. My insurance covers it as diabetes and pays in full. I
don’t even have a co-pay like I do for my test strips and insulin.
–
Liz

Comments on: Pump : X

By: Tom Kacy