Type 1 to pump or not to pump?

 

Pumps are not on offer to everyone, currently you have to meet NICE guidelines before one can be considered. The reason for this is that they are expensive, initially for the pump itself and then the ongoing cost of consumables and test strips. 

This is a link to NICE guidelines. 

https://www.nice.org.uk/guidance/ta151/resources/insulin-pump-therapy-for-diabetes-374892589

I would like to give you my personal view of what pumping has meant to me. Prior to going on the pump my HbA1c results were not within accepted levels and this was not due to carelessness on my part, my basal rates needed to be changed frequently and for no apparent reason. I was told that it must be related to various things- activity, stress, hormones or anything else in my life. I could never reconcile this with what I knew I was doing. My view was that my needs changed without warning. I always felt that I was fighting a losing battle and that I was not believed when I said that I was trying really hard to get things under control.

After going on a pump nearly 4 years ago my HbA1c results have improved greatly, but it has not been an  easy journey. The positive points are as follows. On a pump your basal rate can be programmed to vary throughout the day, for me it varies between 1.2 units per hour down to 0.5 units per hour. I also have varying basal rate programmes as I said previously my needs are quite unpredictable, these vary between 17 units a day to 23 units a day. The flexibility this gives you is really useful. 
Also if I am going to be active I can adjust the rate of delivery from 10% up to 100% at the push of a button. No more loading up with carbs before doing any exercise.
Eating is also more flexible, if you are offered carbs when it is not a meal time it is easy to administer an extra bolus via a handset. Missing meals and having no carb meal is also possible.

The downsides are that you wear it 24 hours a day so are always conscious of your diabetes. You need to do frequent blood tests to maintain control. At security in airports you are nearly always stopped as the alarm sounds going through screening, however they are fairly used to pumps by now and once you show it there is usually not a problem even in fairly remote places. Carrying more equipment around with you means that I always seem to have to have a bag with me or very full pockets.

Weighing all the pros and cons I would not want to go back to multiple injections.

The following website gives good advice if you are considering a pump.
http://www.inputdiabetes.org.uk/alt-insulin-pumps/