Insulin Pump

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DennisJ

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Anyone here riding with an insulin pump? Advantages/Disadvantages? My Dr. at VA has mentioned moving me to a pump a couple of times but I don't know how a pump will respond to riding.

 
Don't do the pump yet, but people that I've talked to like not having the highs and lows. Much more consistent delivery.

 
Ready for the serious answer? They are BAD ASS!!

I've been a type one since I was 16. I avoided a pump for 20 years because my first doc told me, "One day maybe you can get a pump put in you." There was no way I was gonna let anyone surgically put anything inside me. I was afraid I would break it.

Anyway, I've always had very good control, but a few years back, it got really hard...It was making me crazy. Lows were sneaking up on me and taking me forever to recover from. I ended up getting a high A1C result at a Dr. visit because I was having a lot of problems with control.

She recommended a pump and sent me to a Diabetes Education place that specializes in them. I have been using a Medtronic pump since then and couldn't be happier (Well, If I wasn't a diabetic, I'd be happier, but whatever...). Control is way better and much easier. In my job, highs and lows can be very bad things. I have ridden my bike all over the country with it. Ride the dirt bike too. Ride horses, shoot, work, run, you name it.

There is a small infusion catheter that I put into my stomach and move every 4-5 days. NOTHING is permanently implanted. The infusion sets can be ordered with different length tubes, and currently, I use the longer tube, just to clear my vest and have enough to not pull on it. At work, I keep my pump inside my vest. Another guy I work with has his on his belt. Some of us are running the tube down their leg and attaching it to their boot. I use that boot option when I go to the range.

I sleep with the pump connected, and really only take it off for showers and swimming. Medtronic says it is water resistant, but everything is sealed with O-rings, and it seems waterproof, but I donno that I wanna test that out too much.

The pump is good for control and really good for me due to the way it delivers insulin. When I was doing injections, I was using Lantis for the 24 hour baseline control (Basal rate) and Humolog for fast acting needs, like when I eat (Bolus control). The bitch was, if I took Lantis expecting to eat a certian amount over the next 24 hours and something prevented me from eating, I would slowly sink into these lows that were awful.

With the pump, it injects a certain amount of insulin per hour...Like 1.5 units per hour from 0800-1200. It is Humolog or Novolog only. I have different rates for different times of the day...Afer some trial and error, you will get yours straight for you. The pump works on this standard, and the only thing I have to do is adjust for carb intake. So, I stick my finger and my tester tells my pump my BG level. Then I tell the pump how many carbs I'm eating and the pump does all the math and adjusts enough insulin to maintain my BGL from 80-120. If I don't eat, it doesn't matter because the basal rate does not take my eating into consideration...The Bolus rate only comes into effect when I tell it to.

Here's the cool thing, as the pump is not always perfect: If I test and am a little low, but gettin ready to eat, the pump will give less insulin. If I am high, the pump will give more insulin. If I test and am not eating, but am high, the pump will, at my direction, give what it is programed to give to bring my BGL down. If I'm doing something that I know will bring my BGL down, I can decrease the basal rate by percentages to reduce lows.

The pump has not decreased my need to stick my finger...I do it 5 times a day, most days. However, that leads to good control, and ensures that my pump is in line with my metabolism and activity level. I can get a sensor that goes on the opposite side of my body that will talk to the pump about glucose levels, but for now, those sensors work off of intercostal fluid and are; therefore, about 20 minutes behind...They also don't negate the need for the finger pricks, so I'm not gonna waste my time and money until the sensors are better...It is an option that may work for you though.

So...To answer your question, there are almost no disadvantages...A little planning about where I may put an infusion catheter, or getting creative about attaching the pump to my pants or belt so I don't lose it during a ride. A very small price to pay for the increased control and ease of use. It is like wearing a pager...Almost no one knows I even have it. 90% of the people on this Forum I ride with don't know I have it...Until now.

The other disadvantage can be cost, depending on your insurance...When I got mine, my insurance covered 100% of "durable medical equipment" which is what the pump is considered. These bad boys are about $4k. I get 90 days of infusion sets and test strips at a time. With my previous insurance, the 90 day supplies were much more expensive.

We changed carriers, so my strips, insulin and infusion sets are much cheaper now...However, now only 50% of the cost of a new pump will be covered when this pump is done. FWIW, pumps are warrantied for 4 years. My pump's warranty is almost done...I have gone through 4 of them so far. When this one dies, I will have to spring around $2k for a new pump, but it will be a new model with new technology and worth every frigging dime.

Quite honestly, I'm a fool for waiting so long to go to a pump. If I had known earlier how cool it is, I would have done it years ago.

 
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I am not a diabetic but my daughter is and she has been on the pump for the last 10 years. I think HRZ's post summarizes everything you need to know about pumps.

 
I've been insulin dependant for 42 years,went on the pump 9yrs ago A1C's dropped immensly. I had 1 pump go bad,had a new one overnighted. Mine is a Medtronic also. Morning blood sugars are sometimes high,but with the wizzard come quickly under control. My biggest problem is when I do heavy grunt work or bicycling, I can't seem to get it thru my thick skull to turn the thing off when doing such. The pump gives me more freedom to eat some fatty foods, as now with the duel ssquare wave bolus feature. The only other "problem" I had was 2 yrs ago when riding in 100+ heat my insulin "went bad". That could have happened with the pen also. Those temps, I use a cooling vest now. Go for it, you won't be disappointed. BTW when I came down with diabetes, I was issued 2 glass syringes and 5 needles that I had to resharpen on a provided hone stone. They have come a long way.

 
Thanks for the replies. Type II diagnosed in 2003 but I think I had been diabetic since probably the late 80's. Thirsty, early morning urination. My A1C lever is pretty consistently 5.9 - 6.2 and I haven't had a low, below 70, in a long time. Use Lantus and Aspart (fast acting). 10 units of Lantus in the morning and then Aspart before meals using a sliding scale. Testing 5 times a day as do a lot of people. VA will pay for the pump, supplies I think are a co-pay the same way all the syringes, test strips and insulin are.

My real concern is managing the catheter and tubing. I'm thinking it is just one more thing to learn to manage The heat might be an issue when I am over in Eastern Washington or Oregon or down in Northern California but otherwise the Seattle area temps are normally reasonable if not cold.

Thanks again for the great information.

 
Good on ya Zilla ! Thoughtful and informative. Good on you too Dennis for staying in the saddle......" Badges?.....we don need no steenkin' Badges !"

Blessed,

Bobby

 
Wow, what a terrific thread. My wife is diabetic and uses an Animas pump - and will never go back to anything else. HRZ's comments are on the money.

Definitely talk to a diabetes educator, it's well worth the time...

 
I have an entire new admiration and respect for you, AJ...tip of the hat for an intelligent, thoughtful and helpful post.

 
Been an EMT in South Texas over 12 years now, made many, too many, diabetic calls in that time, can't ever recall running on one with a pump. I think Hot Rod gave some good thoughts there. Rrram's right, talk to a diabetes educator, knowledge is power. Good luck, good health and most of all good riding.

 
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