Choosing an Insulin Pump: My Personal Debate

I have decided to start using an insulin pump.

Was the decision scary? Yes, to say the least. In fact I’m still nervous. After 10 years being diagnosed with type 2 diabetes, you’d think I have managing this disease down pretty well. But even after that long time, I’m still learning. I think you never really stop learning.

But first you have to remember that this is a life-long condition. After my second diabetes management class, Insulin Forward, I realized just how rusty I was-especially at counting carbs.

I had just found out that my A1c had reached 13.7%, a number that said I was way out of control. My type 2 has reached most of my body’s systems. I had been having problems with vision because of cataracts that my uncontrolled sugar levels had aggravated. In December 2011, I had my first heart attack at 35 from plaque build-up and hardening of the arteries. I was now diagnosed with coronary artery disease.

As if that weren’t enough, I have just found out that I have the first signs of diabetic kidney disease.

My managed care nurse recommended that I go to an endocrinologist. I started at the Wayne State University Physicians Group’s Comprehensive Diabetes Clinic. The staff there was great and put me into a class to help me right away. The class taught me to count my carbs and introduced me to why I should use the insulin pump.

Generally speaking, it’s people with type 1 diabetes who are the greatest insulin pump users. But recent studies are showing that they have been effective for type 2s whose A1c’s are especially high.

The doctor first needed to determine whether I needed the pump by testing me for 72 hours using a continuous glucose monitor. The monitor was attached to me during a visit, and the process was about as painful as a needle poke. For somebody like me who’s used to injecting insulin, it was a breeze.

The CGM tests you every five minutes, giving the doctor a comprehensive idea of what your sugars look like throughout the day, awake or asleep. After 72 hours it’s removed and the data it has gathered is sent to your doctor.

This allows your doctor to make a judgment not only on whether you need a pump but also your overall treatment plan. After my two-hour class and the results of my CGM report, I decided that I wanted to have more control of my sugar levels. This meant getting a pump.

Most health insurance providers cover insulin pumps since their overall costs are about the same as those using a syringe. I am still waiting for my at-home training and approval for a CGM device of my own. This will worn me if my sugar is dropping too low or trending too high. In addition, my husband will be able to tell if I’m having problems-something he hasn’t been able to do before.

My husband is still worried about my sugar going too low and the possibility that I could slip into a diabetic coma since my insulin will be continuously pumped instead of injected when I need it. But the doses will be much smaller and I will control when I wear it as well.

My Medtronic Revel pump has arrived and is sitting, awaiting its use, and I am anxious to put it on.

But that will be a different story.

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