Transitioning to a pump

Do we have any pumpers out there?  I had RNY about 9 months ago, and am in the process of deciding about a pump.  I've been injecting for 25 years and am finding that my blood sugars and hbA1c's are just not getting much better.  On the advice of my CDE, I'm strongly considering an insulin pump.

I'm concerned about the transition and just the overall change.  I also have anxiety about possible weight gain, although I am religious about carb counting now and keeping all of that in check.  I am still losing - and think I probably have about 20-30 more pounds left - not sure though.

What pumps do people have?  How has it been to use?  I'm really interested in any experience anyone is willing to share.

FYI, I am a type 1.5 - knew surgery would improve my health, but also knew that coming off of insulin would not be possible.  I have insufficient insulin production due to the autoimmune disease that destroyed my beta cells.  Any type 1's out there on pumps?

Thank you!

 I use a Medtronic Paradigm Minimed pump and have been for 3 + years. I was on Lantus and humulog pens for years prior to the pump. My overall control and a1c improved. I had deveoped antibodies against Lantus and it stopped working. Being on the pump makes carb counting a breeze. Once you get your settings right, you put in your fsbg then your carbs. Then the pump suggests a dose. You can choose to give all at once or do a "square" dose that lets you choose how long to let the bolus inject. This is helpful for covering the slower effect of fat and protein on your sugar.You can choose to give a certain amount to cover the carbs and the rest of the bolus is given slower and you can choose how long .
Continuous glucose monitoring is possible to track trends and patterns .I did that for a while. The sensors were difficult to keep on. I kept sweating off the adhesive and had to use creative taping methods to keep the sensor from falling out. I live in Florida and I sweat a lot! Anyway pumping is the way to go. If you have good insurance to cover pump supplies, go for it! 
Denise

Denise - thank you SO MUCH for this info and your experience.  It's so helpful.  I'm just not getting good results, despite carb counting and ratios and charting and on and on.  I guess I am very afraid too of weight gain, but I'm really so diligent about all this that I think it will be ok.  My CDE joked about how, when he first went on a pump, he headed right to the bakery, loaded up and then bolused like mad.  If I start doing things like that, which I really can't even FATHOM, I guess I will gain weight.  But, if I continue to work diligently, I hope to be OK.

I'm 10 months out from RNY with a weight loss of 75 pounds to date.  I have stalls for weeks, but then they break lose and I get a big weight loss.  Then another stall.  I likely have another 20-30 pounds left, but who knows.  Currently weighing in around 177 at age 55 and 5'4". 

Thank you - truly!  This is exactly what I need - and the info about CGM was also very helpful as I've wondered about that too!

 Im a pumper too. I use the same one and I have the sensor that I use weekly because I'm a brittle diabetic.  I have been on a pump for 24 years. First female child on a pump when I was 11.  I believe it saved my life and they have come a LONGGGGG way.  Freedom comes with a pump.  You only gain weight if you take advantage of the freedom tho LOL  Heck, I have been on a pump so long that I wouldn't know how to give shots if I needed to do it!  Another thing that is cool with the pump is that you can reduce or increase your insulin by percentage also. I think this will be very helpful when I have surgery (Im preop).  I can just cut the whole thing by 50% and see how it goes.  Ask me ANYTHING!

hi

I am a type 2 and on pump. Medtronics  Mini Med  over 3 years.  It is much better then shots IMO.
If you are carb counting you will not have any problems  adjusting to a pump.  the pump helped me to keep my sugars level. 

Ladies - thank you all for your advice and comments.  They are very reassuring!! 

My next step is to go through my pump choices and then start the process.  I'm sure I will have lots of questions as I make the transition, and will likely call on you all again for works of advice and reassurance.  Thank you - truly!

I'm on the Medtronic Paradigm pump. It saved my life!! I was on 4 shots a day and still had lousy control. So about 10 years ago, I made the transition. Last June I had the RNY. I had to get my A1c below an 8. I did it with the help of diabetic nutritionists. I have lost over 145 pounds in a year and my A1C is 6.8! The pump gives you so much freedom and flexibility. At first, it seems overwhelming--so much information, but it is so worth it. You can call Medtronic and ask them to check out your insurance. They will even send you a pump to just try out. They handle everything!! Don't be afraid. You can always say no. Good Luck!!

thanks for sharing your experience - this is great news.  I don't feel fear about it - just a lot of questions.  My diabetic educator is fabulous and very helpful, but I don't think he has really worked much at all with RNY grads.  He met me after I'd lost 75 pounds, so in some ways, he doesn't totally have an appreciation for what I've been through that way.  And, I just don't want to make a move that is going to make me gain any weight.  Overall, though, good control is my goal.  That is why I did the surgery in the first place!

I really appreciate your comments - that goes out to everyone.  It sounds like Medtronic is one of the more common pumps.  I have some reading to do on the different options.  My CDE gave me some great summary sheets that give the pluses and minuses of each.  There is one that does not have tubing - it is a little pod on the skin, but you need a remote with you to input any boluses.  I wanted to check that one out a bit more too, because I liked the idea of it not being noticeable.

How is it to sleep with a pump?  Do you have a continuous glucose monitor?

It is a little awkward at first learning to sleep with pump. I attach it to my pajama top in the middle so I can sleep on either side. I am back on pump now for a few days. My daily basal rate is at 0.4 units an hour.  The levemir did not seem to be holding me very well. Now I can bolus my carbs at lot easier. I am somewhat disappointed that my sugars are still up, but I am only 3 weeks out and have a long way to go. I do not want to have to take metformin again. I guess it all depends on my next a1C result. I did use the CGM but it its tricky and another needle to place it. I had problems with securing it and not sweating the darn thing off. It gives great info, so if your insurance covers the supplies, I would try it just for the information it will give you about how your sugars cycle during the day. Keep in mind that it is not a basis for insulin dosages! It only tracks trends.  Your endo can use this information to do pump adjustments if you are getting too many lows or highs on your graph. The carelink print outs are valuable.
Do keep in touch!

I have been type 1 since I was 3 years of age (I am now 35).  I have brittle diabetics, and was not interested in the pump as I dont like the though of a needle always being inside of me.  I am having RNY surgery next week and hopes that it will help my controls.  I am on 5 shots a day.
Total lantus 58 units, and total humalog 60 units.