Re: The pump vs MDI

[Guest guest]

In a message dated 12/17/04 7:20:56 PM Eastern Standard Time,

koresun@... writes:

>

>Lately, though, I find that my multiple daily injections hurt more than they

>ever did before. I have no idea why. I can't help wondering ... how do people

>manage with a needle sticking in them 24/7?

>>>>>>

Actually, it's a teflon cannula not a metal needle -- and the insertion

needle doesn't stay in, it's the cannula that stays after the insertion (though

some apparently do choose a meal cannula). From what I've learned on the

pumpers

list, the vast majority of the time, you don't notice it at all (except when

you first start and are getting used to it or when the tubing catches on

something and yanks you -- luckily there's tape to keep it connected to you).

Sometimes the site gets irritated and you have to change it, but that's rare.

But, normally you change it every 2 to 3 days. One injection every 2 to 3

days really appeals to me. I've only been injecting since June and I really

hate it. It hurts, especially as my monthly cycle approaches when it hurts a

lot.

Yeah, the idea of being connected to something 24/7 seemed a bit strange when

I first thought about it, but in a sense I'm connected 24/7 to the needles

and pens and such too - they're always with me.

The BG swings I'm dealing with now are driving me nuts, affecting my

depression, affecting my general well being, making me irritable and tired. All

of

this combines to make me worse at self care, which isn't a good thing. The pump

doesn't solve all of life's problems, but I think it will allow me to deal

with diabetes better.

Stacey

[Guest guest]

<< Lately, though, I find that my multiple daily injections hurt more

than they ever did before. I have no idea why. I can't help wondering

.... how do people manage with a needle sticking in them 24/7? >>

Hi Dianne,

While some sets *do* still include a needle that remains under the

skin, most of the infusion sets that are used now are inserted with a

needle, but the needle is then quickly withdrawn, and the only thing

that remains under the skin is a very small, very thin, teflon

(plastic-like, bendable) cannula. Depending upon the particular set,

these can be 6mm, 8mm, 9mm, etc. in length. I use two different types

of infusion sets -- I interchange them every other set change -- and

neither use a needle. I use the Disetronic UltraFlex, 8mm, which is a

straight-in 90 degree angle set, but my favorite type of set (and the

one I've used for *years*) is the Comfort/Silhouette/Tender, which is

an angled set, that is inserted under the skin at a shallow angle,

typically no more than 30 degrees. The only time I ever *feel* the

cannula on an infusion set is if the set becomes irritated -- or if

it's left in too long. I can count the times that I've actually felt

the cannula on my hands, and I've been pumping a total of almost 5.5

years (on for 4.5, off for a year, and back on since February of

2004). Most of the time, I'm not even consciously aware of the pump

being there.

I don't recall there being a lot of pumpers on this list. I was a

terrible failure on MDI, and an even worse failure using

NPH/Regular/Humalog in the year after my diagnosis before I started

pumping. Lantus gave me *hideous* hypos -- worse than I've ever

experienced in the seven years since my diagnosis. Although I'm

extremely sensitive to insulin and have experienced more than my share

of hypos, it wasn't until I started using Lantus that I experienced

hypos that caused me to fall unconscious. Every afternoon at 4:30, no

matter what I did -- I would experience a hypo. There was simply too

much insulin circulating in my bloodstream that I couldn't adjust --

and nothing I did to adjust the Lantus dose seemed to make a bit of

difference. I had one hypo while on Lantus that almost caused me to

crash through the window of my third-floor apartment; I was stumbling

around on the floor, and my legs were gashed in and bruised so badly

that it looked as if I'd been struck by a bat. The next morning I had

an appointment with my endo. I told her, " this is the result of the

latest one... " and lifted my skirt so she could see my legs. It was

at that appointment that we started the process of getting a new pump.

The adjustable basal rates on the pump are a godsend. You cannot

achieve that on injections of Lantus or UL. And as I said earlier,

the infusion sets are a non-issue.

Hope this explains it a bit.

[Guest guest]

...I'm so glad that the pump is working for you. However the

hypos you experienced with Lantus were almost certainly the result of

improper and inappropriate dosing - and your doctor should have known

that and lowered the amount of Lantus you were taking.

One of the main problems with Lantus is that it is relatively flat This

works fine for some people but definitely not for others. A lot -

maybe even the majority - of diabetics on insulin have insulin

requirements that differ during the day. That's one of the reasons UL

works so well -- you take it twice a day and can adjust for this. As

I've mentioned earlier, my UL dose is slightly more than half of my

evening dose and this works very well for me.

So if you're one of those people with an uneven insulin requirement, the

amount you need in the morning to cover your dawn rise would be entirely

too much in the afternoon and this is clearly the reason you went hypo

so regularly.

I'm surprised that this didn't occur to your doctor. OTOH, what

doctors -- even endos -- learn about insulin dosing in medical school

is so woefully inadequate that I guess I'm NOT so surprised.

Vicki

Re: The pump vs MDI

>

>

> << Lately, though, I find that my multiple daily injections hurt more

> than they ever did before. I have no idea why. I can't help wondering

> ... how do people manage with a needle sticking in them 24/7? >>

>

> Hi Dianne,

>

> While some sets *do* still include a needle that remains under the

> skin, most of the infusion sets that are used now are inserted with a

> needle, but the needle is then quickly withdrawn, and the only thing

> that remains under the skin is a very small, very thin, teflon

> (plastic-like, bendable) cannula. Depending upon the particular set,

> these can be 6mm, 8mm, 9mm, etc. in length. I use two different types

> of infusion sets -- I interchange them every other set change -- and

> neither use a needle. I use the Disetronic UltraFlex, 8mm, which is a

> straight-in 90 degree angle set, but my favorite type of set (and the

> one I've used for *years*) is the Comfort/Silhouette/Tender, which is

> an angled set, that is inserted under the skin at a shallow angle,

> typically no more than 30 degrees. The only time I ever *feel* the

> cannula on an infusion set is if the set becomes irritated -- or if

> it's left in too long. I can count the times that I've actually felt

> the cannula on my hands, and I've been pumping a total of almost 5.5

> years (on for 4.5, off for a year, and back on since February of

> 2004). Most of the time, I'm not even consciously aware of the pump

> being there.

>

> I don't recall there being a lot of pumpers on this list. I was a

> terrible failure on MDI, and an even worse failure using

> NPH/Regular/Humalog in the year after my diagnosis before I started

> pumping. Lantus gave me *hideous* hypos -- worse than I've ever

> experienced in the seven years since my diagnosis. Although I'm

> extremely sensitive to insulin and have experienced more than my share

> of hypos, it wasn't until I started using Lantus that I experienced

> hypos that caused me to fall unconscious. Every afternoon at 4:30, no

> matter what I did -- I would experience a hypo. There was simply too

> much insulin circulating in my bloodstream that I couldn't adjust --

> and nothing I did to adjust the Lantus dose seemed to make a bit of

> difference. I had one hypo while on Lantus that almost caused me to

> crash through the window of my third-floor apartment; I was stumbling

> around on the floor, and my legs were gashed in and bruised so badly

> that it looked as if I'd been struck by a bat. The next morning I had

> an appointment with my endo. I told her, " this is the result of the

> latest one... " and lifted my skirt so she could see my legs. It was

> at that appointment that we started the process of getting a new pump.

> The adjustable basal rates on the pump are a godsend. You cannot

> achieve that on injections of Lantus or UL. And as I said earlier,

> the infusion sets are a non-issue.

>

> Hope this explains it a bit.

>

>

[Guest guest]

I don't like the shots either, I just accept the necessity. They hurt,

I frequently bleed and I always have black and blue marks. However, my

needs are fairly consistent from day to day in terms of lesser and

greater times of insulin resistance. One daily shot of UL works for me

along with, usually, four shots of humalog. The peak and valley of the

UL works with my peaks and valleys; the humalog can be used for

corrections, if necessary. My IR is greatest in the morning, my rise is

after I get up, I am not hungry then anyway, so I simply shoot two units

of humalog to control the rise, adding a correction factor if I wake up

over 110.

Stacey, in your case with widely swinging insulin requirements during

the day, some built into your body, others perhaps from daily,

differing, circumstances, I don't think any insulin would be flexible

enough to offer good control all thru the day - except little bits of

humalog all day long. Surely a need for 10 or more shots a day meets

the requirement for a pump.

Good luck in getting it soon!

Helen

[Guest guest]

My daughter would never give her shots in the stomach. Somehow that

just grosed her out. Now she is very happy with the pump even though

that is in the stomadh. She says inserting it is a little more

painful than a shot but once every 3 days is much better than

multiple shots. She put off getting a pump for a long time. She was

leary of the pump mailfunctioning and then there is the stomach

aspect of it. She is well pleased with it.

Betty

>

> Actually, it's a teflon cannula not a metal needle -- and the

insertion

> needle doesn't stay in, it's the cannula that stays after the