Why the insulin pump?

Well, I officially now a 'pumper', or so I am told. After 8 months of planning, pondering, setting goals and countless hours of Internet research, the day arrived when I would officially become an insulin pump user.

For those who don't know this, type 1 diabetes is a chronic condition in which the human body can no longer produce insulin. It is usually diagnosed in childhood or early adulthood (although recently, many more people are being diagnosed later in life) and is not related to weight or unhealthy lifestyle. The body requires a certain amount of glucose in order to function properly (as a rule, between 4 and 7 mmol). For type 1 diabetics, in order to maintain these sorts of levels, multiple daily blood tests must be done, insulin must be injected using either an insulin pump or multiple daily injections (MDI). Type 1 and 2 diabetes are often confused, but as I am a type 1, I choose not to comment on type 2, as I don't have the right or experience. But as a type 1 after 23 years, I am an expert. Or as much of an expert as anyone can be with a condition which regularly throws in surprises and confusing results.

I started out on 2 injections per day, which meant weighing food and tiresome calculations as to how much I could eat and when. At the age of about 14, the specialists as the hospital gave me the option of going on 4 injections a day, which soon became 5. This gave me a lot more flexibility (you can eat bigger meals and take larger doses, or eat less and only inject according to your needs). However, after years of trying to gain better control, it was clear that something still wasn't quite right. So, after much thought and consideration, we (yes, because to choose to go onto a pump will involve those around you) decided to go on the insulin pump.

The insulin pump is a mobile phone sized device which is attached to someone for around 23-24 hours per day. Rather than having to do MDI, the pump stays connected to you via a flexible needle, cannula and tubing. It remains at the same site using a strong plaster like material which sticks to the skin and keeps the needle in place, usually for 2-3 days at a time before the site needs to be changed to avoid infections and soreness. After all, your body is never going to like having a piece of plastic inserted into the skin, even if it is keeping you alive! Throughout the day, the pump will deliver minute doses on insulin, which can be adjusted to release different amounts at different times of day, according to the needs of the person using it. For example, my sugars often run higher in the afternoon, so my dose will be higher during the afternoon hours. Then, if you want to eat, you calculate how much your intended meal will require and you give yourself an extra dose (using the pump again - still no more needlesticks!).

Although it may seem strange to want to be connected to a machine for you whole day, the constant reminders of what poor control and erratic sugars can do to a person is pretty powerful (kidney failure, blindness, heart disease and gangrene to name a few). In the US, from what I hear, you can only get a pump if you are adequately insured and are prepared to put your case forward that you should be allowed to have access to new medications. If you do not have insurance, you pay. A lot! In the UK, although the pump only became more recognised in recent years, the pump is free. As long as you complete a successful trial and can prove that it is in the interest of the primary care trust to fund your treatment, you should't pay for a single thing. One heartbreaking moment that woke me up a bit was when I was reading extracts from an insulin pump chatroom. A mother was on there asking if she could buy someones old pump, with the limited resources she had. How could I turn around and say I didn't want to try the pump in case it affected my sleep, while there were people out there asking for second hand pumps (a no-o) in a desperate attempt to better their children's lives.

I have reached the age where having children and good health are important to me and having tried for many years to gain control, this seems like the only (and by far the best) option for me.

So for me this was an exciting year, learning all about the benefits and pitfalls of life on a pump. My next post will be about the pump I am on, my experience of putting it in for the first time and the bag fulls of freebies I came home from the hospital with (an no one can deny, freebies always make you smile)!

See you soon!