Injections

Does An Insulin Pump Make Me Lazy?

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In a recent blog post, I expressed that my insulin pump has offered a greater level of convenience in giving my insulin doses. I lamented that I was often slack with carbohydrate counting, weighing my portions and delivering insulin in a timely manner when I was on injections. This led to a few comments from social media trolls that accused me of getting an insulin pump because I was lazy.

Of course, I could absolutely count carbohydrates, weigh portion sizes and pre-bolus insulin on injections. But there were a number of other factors that lead to my ultimate decision, which I wrote about here. I felt failed so often despite my best efforts, that I simply lacked the motivation to do those things that I should have.

So in hindsight, maybe ‘lazy’ was the wrong word to use. I only used it in the context of trying to be honest. However, an insulin pump is definitely not a lazy decision.

Attending an insulin pump information evening was not lazy. Doing my research was not lazy. Making an appointment to discuss pumping with my diabetes educator was not lazy. Going home and giving myself three months to think about the pros and cons of pumping was not lazy, despite how tempted I was to say yes. Being active and seeking out options that may improve my health is not lazy. Wanting to better manage my diabetes is absolutely not lazy.

The very first thing that Gwen drummed into my head is that an insulin pump is not any easier than injections. In hindsight, I would argue that it is much more work compared to injections. There’s a good reason why clinics like to make sure that their patients are deadly serious about it and prepared to make a commitment. Wearing an insulin pump is a big responsibility. Just read every post I’ve written here in the past three months.

I am very conscious that I’ve been writing a lot about insulin pumping here of late, but that’s simply because my insulin pump is a big part of my diabetes at the moment. I certainly don’t have an agenda to ‘push’ insulin pumps onto anyone. I don’t believe that one is any better than the other. I simply believe that different methods of insulin delivery may suit some better than others. There’s a big difference between giving advice, and sharing my experience in the hope that it might inspire you.

Insulin pumps and diabetes tech are often the hot topics among bloggers and diabetes websites, and it sometimes does leave injections looking under-represented. But then again, don’t we all feel we are in the minority in some context or another? I feel in the minority because I can’t play sport to save my life. I feel like I’m in the minority because I don’t work in an office. At work this morning, I’ll be in the minority because I’m the only person who watched Australian Survivor last night. And in the DOC, I feel in the minority because I don’t use a CGM. 

Truth be told, I couldn’t care less about being in the minority! I’m happy to go for a walk instead of a run. I’m happy that I’m employed, earning money and have goals that I’m working towards. I love Survivor. And I’m happy to prick my finger 15 times a day, because that’s what works for me.

It comes back to the point I made last week in this post about inclusiveness. If there’s a topic that speaks to you, then please do add your voice to the conversation. And if I’m reading it, I promise I’ll treat it with absolute respect.

Finally, an insulin pump does offer me the convenience of dosing insulin under the table, or when I’m on the go. Dealing with diabetes every day for the rest of my life is already hard enough, and I refuse to feel guilty for it.

Three Month Pump-aversary!

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The very first thing Gwen emphasised to me last year was that using an insulin pump would not be any easier than Multiple Daily Injections. Boy, oh boy, was she right.


These past three months have been by far the most challenging I have faced since being diagnosed with type 1 diabetes six years ago. I have gone through site failures, occlusions, ketones, frustrations and burnouts that have lasted for several days on end. It has required enormous patience, a commitment to learn, and it has seen me agonise over many a decision. I have been through it all. I have poured my heart onto these pages over the last three months.

There have been a lot of low points that I have talked about quite candidly over the past three months. There have been a few times where I’ve reached breaking point. Times where I have found myself pacing up and down my room, deliberating over whether to rip my pump out and take a break for a couple of days.

But every time I have contemplated removing my pump, I knew that I really didn’t want to say goodbye to that added level of precision. I have never truly felt ready to say that this wasn’t for me.

Stability during the night is miles better compared to injections. I felt that when I was using Lantus, I could never get the dose quite right. I felt that I needed to eat a similar number of carbohydrates each day in order to achieve that smooth coverage I needed during the night. I felt that if I ate more than normal, my basal wouldn’t be enough to keep me stable through the night. Then if I were to skip a meal the next night, my basal would likely send me plummeting at 4am.

For the first time in my life, I have confidence that my basal rate keeps me stable. When I give a correction at 1am, it actually works and sends me back into range by the time I wake in the morning. When I go low during the night, it’s only through my own fault.

I could never seem to get my breakfast insulin dose just quite right. In the months leading up to the pump, I noticed that I would end up frustratingly high after eating virtually the same thing for breakfast each morning. Now my pump delivers extra basal insulin to cover the extra glucose that my liver dumps when I wake up each morning, and my breakfast insulin dose actually does it’s job!

Highs are also so much easier to manage with the pump. I remember stubborn highs that were so resilient they needed multiple insulin corrections that didn’t make any sense. Now with the pump, I know that highs are a little less sensitive to insulin. When my levels soar into the 20s, I can set a temporary basal rate of +200% to get things moving a little more quickly. When i think about it, I don’t think my levels peak above 15mmol half as often as they used to. And when they do, they don’t stay there for too long at all.

On pump day, Gwen reminded me that I was the kind of person who wanted that extra level of precision. I knew that I wanted to be able to customise my insulin delivery to match the hour of the day or a specific activity. I feel that my insulin pump has given me that.

The pump has given me an added focus and drive with my diabetes. I am working my butt off with carbohydrate counting, pre-bolusing and watching my portion sizes (which I could easily do without the pump, too). I guess what I’m trying to say is that my diabetes goals seemed unattainable on injections. With the pump, they do. Hence, the drive to keep up the hard work rather than being lazy.

I’ll hopefully have an a1c result at the end of today. I have a good feeling that it will likely be around the same mark as it was in May, and I’m pretty content with that. Over the years my a1c results have been ridden with too many peaks and troughs, so I’m pretty pleased that those peaks are a little less peak-ey today.

As I reach the three month mark on an insulin pump today, I feel like I can finally focus on some of my other diabetes goals, which feel far more in reach than they ever did on injections.

Thanks for all of your support and encouragement over the last three months. I really couldn’t have done it without you all cheering me on.

Pump Doubts

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After a few infusion site failures of late, I’m starting to become really self conscious. After every new site change, I become really paranoid of whether it’s a failure or success.

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I poke my infusion site, trying blindly to detect a kinked piece of teflon that should be sitting underneath my skin. I prod around the infusion site on my stomach, trying to feel bruising and pain. I stand still while my pump is delivering an insulin bolus, waiting on edge to detect any stinging. I lift up my jumper compulsively, watching the colour of the skin underneath my site like a hawk.

I think about whether the skin tissue underneath my infusion site is strong enough to handle 3 days worth of insulin boluses. I frequently glance at my Total Daily Dose history on my pump, questioning whether it’s too high. I feel guilty for the carbohydrates I am consuming, for the sake of the subsequent insulin boluses that will have to go underneath my skin.

I check my levels like crazy after a site change, impatiently looking for signs that the insulin is heading successfully underneath my skin. I keep an eye on glucose movements like a hawk. In a moment of paranoia on Saturday, I even ripped out a perfectly good infusion site because the correction was taking too long to work it’s magic.

I draw dots on my stomach in permanent marker, in a desperate bid to keep on top of site rotations. I stare persistently at the real estate on my stomach, deliberating over just the right spot to place my new infusion site. I worry about how soon I will be able to re-use an area of real estate again.

In moments of site failures, I question whether this is really worth it. I think about results around my diabetes, and I’m almost certain that I won’t see any improvement yet. I’d be lying if I said I haven’t had fleeting thoughts that maybe this is not working for me. I worry that I won’t be able to make this work for me. I stand in my room for minutes on edge, pacing, deliberating over a site change or a shot of Lantus.

But when I think about going back to Lantus, I think about the level of control I will lose around my basal insulin rate. I think about how unfocussed I was on injections, blindly guessing and correcting all the time. I think about all of the time and investment I’ve put into this insulin pump, and I know that I’m not ready to pull away from it just yet.

More Reasons For The Insulin Pump

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It feels like forever ago that I made the big decision to switch to an insulin pump, and now the big day is only two weeks away.

Over these past couple of months, one of my reasons for making the big switch is becoming much clearer.

I cannot wait to be able to fine tune my insulin to better suit the time of day.

I usually head to bed at around 10pm most nights, which is usually before all of my rapid acting insulin from dinner has worn off. I often find myself needing a good correction dose later on, and I’m not awake to be able to do this. If I’ve eaten something really Low GI like Pasta, it often needs some delayed insulin to cover it. If I’ve eaten something higher in fat or protein, ditto. So most nights, I end up setting 1am or 2am alarms which allow me to test and correct. It’s a lot of work.

Lantus tends to work best when I eat a similar amount of carbohydrates each day. Some nights, 10 units isn’t enough to keep me stable through the night. Some nights, 10 units will send me plummeting to lows. Other nights, my blood sugar will hold nicely until 4am, and then begin to plummet. Ideally, I imagine that my pump would be able to deliver a heavier background insulin rate between say, 10pm and 1am, and then a lighter rate for the rest of the evening.

Part of me is ridden with guilt. I feel like I have failed injections, and that I should have been able to get them right. I question whether I am getting the pump to be more lazy with my diabetes. I feel guilty for demanding an expensive piece of diabetes technology, when other people in the world can’t afford insulin alone. I feel guilty for not having the willpower to follow a regimented diet. I feel like I have a bad diet, simply because I can’t get my blood sugar levels quite right around the food that I eat.

However, none of this could be further from the truth.

I am working hard – extremely hard – with a very demanding condition. A condition that never lets me rest, and is changing all the time. I am striving, constantly, to do better. I know exactly why I am getting an insulin pump, and what I want from it. I haven’t made this decision lightly. I don’t eat exactly the same thing day in and day out. I enjoy variety in my diet, and I don’t apologise for it.

I’m going to try and stop feeling so guilty.

It’s my diabetes, and my choice in the way that I manage it.

Let the final countdown to pump day begin…

Stamp Of Approval

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“You want a pump, don’t you?” Gwen asked me in the hallway outside of her office on Monday afternoon.

“The doctor’s written here in your file that you’ve made up your mind and that you want a pump. Have you picked which one you want?” 

I knew which pump I wanted. It’s not like there was a huge choice to pick from, anyhow. I guess I was just a little surprised at how quickly things were moving. I honestly thought that I would have had to justify to Gwen why I wanted the pump.

“Right, I don’t think I have any of the Animas forms left,” Gwen replied as she hurried off towards Reception to retrieve paperwork for the Animas Vibe insulin pump that I’d picked.

We sat down in her office, where I was met with a stack of paperwork. We completed the order form for the pump itself. We completed forms to be sent off to my health insurer, who would be covering the cost of my pump. We completed forms to be signed off by the endo. We completed forms to be sent off to the NDSS, in order for me to be eligible to purchase subsidised pump consumables. We talked through order forms for the consumables that I will need to purchase prior to pump day. And we completed content forms so that everybody has permission to liaise with everybody throughout this whole loooonnnnnng process.

Gwen grabbed her diary from reception, flicking through pages in search of a block of free days for pump fitting. We eventually settled on a Monday and Tuesday in mid May, where I would be hooked up and trained under the supervision of both Gwen and a representative from Animas.

Gwen has been a significant part of my diabetes journey since the day I first walked into her office nearly six years ago. She’s been the one of the few constants I’ve had among an array of rotating diabetes healthcare professionals. I felt as though I owed her an explanation as to where my decision had come from. I felt like I needed to explain to her why I was abandoning the method of injections that she had taught me to do. In some way, I felt as though I needed her stamp of approval in order to move forward with this scary new way of managing my diabetes. 

But the words were struggling to escape from my mouth. I was overwhelmed.

“You don’t need to explain it to me,” Gwen said.

“I do. I never made this decision lightly. That’s why I didn’t decide straight away back in November. But injections are a lot of work. I don’t do the same things every day. I don’t eat the same meals every day. I don’t live that regimented lifestyle that seems to produce those good results. I feel like I owe it to myself to give the pump a go. My hba1c has been fluctuating within the range of a point over these last few years, and I’m aiming for it to be more stable and at the lower end of that range.”

But no matter how many words I managed to string together that day, I realised that this wasn’t Gwen’s decision to make. It was mine. It was a decision that I made for my own diabetes, and my own life. It was a decision that I will have to own. Right now, it’s a decision I’m damn well proud of.

Gwen totally respected that this was my own choice to make, and she never once tried to sway me either way. But it was still nice to feel a stamp of approval in her final words.

“I think you’ll enjoy pumping. I think it will give you the edge that you’re looking for.”