I don’t come to praise insulin pumps, and I don’t come to bury them. Instead, I am here to tell the truth, from my experience.
I’ve worn a pump for more than four years. In many ways, it’s been a fantastic experience. I’ve enjoyed a tighter level of control, and it’s made dosing more convenient. However, I’m not someone who evangelizes pumps at all costs. They’re not for everyone, and even their best qualities come with significant trade-offs.
One of the basic premises of wearing an insulin pump is flawed, at least in my experience. And that’s the promise that a pump somehow reduces the presence of diabetes in your life, or transforms it into a mere inconvenience.
Actually, pumps make diabetes much more real and a present factor in your life. Why? Because they force you to think about the disease more often. Yes, you can more successfully imitate a pancreas — you can give yourself a multitude of tiny doses of insulin throughout the day- but you have to have the presence of mind to actually input those doses.
It’s also impossible to consider pumps fairly without taking blood sugar checks into account. If you use the flexibility of the pump, you’ll also need to know what your blood glucose levels are doing at all times. That means more test strips, used more often.
Your doctor or medical team might advise a continuous glucose monitor- but that’s not a panacea, either. Because once you have one of those, you’ll be checking it even more often than you were checking your pump. After all, you’ll be receiving a new blood glucose reading every five minutes or so.
Finally, the promise of these devices sometimes outstrips our very human tendencies. Do you bend over at the waist a lot in warm weather?
Does your pump adhesive come off? Do you forget to calibrate your CGM? It can drift off target by dozens of points. You put the pump on incorrectly? You might not get a full flow of insulin.
At least in the days of needles and strips — and only needles and strips — you had a fair amount of certainty about what your blood sugar really was and how much insulin you were actually getting.
Don’t let me scare you off, though. I wouldn’t trade my devices for anything, not now. They’ve permitted me to achieve control I wouldn’t have thought possible. They’ve allowed me peace of mind while exercising and eating unusual foods. They’ve given my doctors hard data to analyze.
But as we start on this journey of looking at the joys and sorrows of life with a pump, let’s not kid ourselves. These devices take time and effort to use correctly. Be safe, and know your stuff.