To pump or not to pump – that is a choice

I love insulin pumps. I frequently say they are the best way to mimic a functioning pancreas (for those without a functioning pancreas)*. Currently, I am not on a pump. I went on a pump in 1996 because my friend and colleague had one and loved it. I wore it for one year (almost to the day) and then went off. My endocrinologist was shocked and said he had only known one other person who ever willingly went off their pump.

In 2003 I had two kids: 3 and 2 years old. I was on a plane with the two of them one day, when I decided taking injections was just not convenient with two little kids (and on an airplane). I went back on an insulin pump. I wore that pump for three years and then went back to injections again. I haven’t been back on a pump since.

The reason for all this on and off stuff is because I experience a rare situation called “lipoatrophy” or “atrophy” for short. Because no one can tell me definitively what causes atrophy, I’ve developed my own theory. I believe it is caused by an allergic reaction I had to the animal-based insulin that I injected for years as a child. Now, when I don’t inject into a site (legs, buttocks, arms, abdomen), I get indentations in the fatty tissue (this is atrophy). When this happened in 1996, I was actively dating and felt the “holes” in my legs, etc. were especially hideous looking. I used to say, “I’m too vain for the pump”. Then in 1998 I got married, no longer had to date, and so in 2003 I was ready to try again.

My second time on the pump I lasted a lot longer, until, in fact, I had no sites left in which to put the infusion sets. I finally gave up and went off again in 2006. When I am not on an insulin pump, I actually inject insulin all around the areas of atrophy and build them up with hypertrophy (raised areas usually caused by overuse). And the sites look normal again, by the way.

I’m ok with injections. I can achieve almost the same level of blood glucose management with injections as I can with a pump. But it’s more work. You never know what you can do with diabetes management until you go off the pump. Just try to draw up 2.475 units in a syringe. Can’t be done! There’s no such thing as a dual-wave/extended bolus or a temporary basal rate with injections. These pump features just can’t be matched. I strongly believe that insulin pumps are the way to go, if someone wants to be on one. I also believe that by paying attention and putting in the effort, diabetes can be successfully managed with injections.

Which did you choose (and why)?

*Most people with diabetes really do have a functioning pancreas, it’s just that the 1% of pancreatic cells that make insulin don’t work as well as they need to or at all. The pancreas has another very important function: producing digestive enzymes!

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