I agree with everything Terrie has said. But I would like to add that when I started on the pump several years ago my doctor told me that I needed to be aware of what I was eating. She then went on to explain to me that a LARGE percentage of her patients that switched from MDI to pumping put on extra weight in the beginning. It's not the pump and the way insulin is delivered that actually causes the weight gain. She explained to me that with a pump it is so much easier to push a few buttons, eat carbs, see something else you want, push a few more buttons, etc...and the cycle continues. You don't have to constantly worry about going to the restroom to inject or having to take time to fill syringes. Pumping makes the delivery so much easier and faster that you don't have to feel like "Dang it, if I eat this then I'm going to have to fill a syringe and go somewhere to inject" I hope that makes sense! And yes I did gain after starting on the pump because I was not thinking about the consequences of being able to eat more easily at the time.

I've been on my T:slim for just over a month and I love it! Previously my A1C was 14+% but in only 3 weeks it dropped to 8.6! I've not seen an A1C below 11% in like 14 yrs (22.5yrs diabetic). No it doesn't make you fat, it uses insulin just as the injections do but with more control. You can't stop your long acting insulin if your blood sugar is going low with injections but you can with a pump. I sleep with mine clipped to my shorts or a sports bra. It may be awkward if you are intimate if you aren't in a long term relationship or if it's the first time with the partner (not sure your relationship situation so just covering *kitten* aspects). My boyfriend is great when it comes to being intimate with me on the pump. He makes sure that I'm not using an extended bolus so that i don't have to keep wearing it while we are together. Then a lot of times if he undresses me he treats my pump as if it's an article of clothing (just doesn't throw it on the floor like he does the clothes...lol), and if it's me initiating the intimacy then I take it off before letting him know I want to play. And he's very gentle around where my site is at the time. One thing, clothes with pockets and pants with little holes in the pocket so it's easy to feed tubing through if you have the site on your leg or butt. Be sure to really look into the different pumps so that you get the right one for your needs. Good Luck and let us know what you decide!

Jenn

Carly,
You will find that a pump will free you once you learn how to let it. Most important is knowing your basal rate, your insulin to carb ratio, your duration of insulin activity and your correction factor. You will need to buff your carb counting skills. MFP can help if you log all your foods. I have my food log set to show carbs, fiber, protein and then fat as all of these are needed to decide your bolus for meals.
Good books to read are "think like a pancreas", "pumping insulin" and " your diabetes science experiment" Do your homework first before getting a pump. These books will help you to find out how to find these numbers -- it is important to know how to do this since as life happens they will change. Sometimes more often that you would like.
In fact I would recommend getting a CGM first as it will truly open your eyes to what your current habits do to your blood sugar levels.
When you have things set up properly you will not need to chase after lows due to too much insulin on board and you will not have to eat a meal because you will go low due to too much background insulin. It makes it easier to stay on an even keel when you are physical active as you can set your rate up from hour to hour.
I'm very active during my work day but tend to veg out when I get home - I can adjust my basal rate to accommodate this and I do not need to eat extra unwanted calories to keep me level like I needed to on MDI.
Pumping is not for everyone but if you do the work and learn how to make adjustments as life happens then you can achieve tight control with good A1C' s without frequent lows. The lower you can keep your A1C with out going below 70 the better your quality of life in the long run.
Pumping will let you do anything in your life - dispite having T1D - you just have to learn the ropes, be willing to take charge and experiment with how you do things till you find what settings will work for all of your activities - be it school, job, vacation, competitive sports, hiking, swimming, camping or being intimate. Some times you need to disconnect from the pump, sometimes you need to use a temporary rate to cover being more or less active but being on the pump gives you the ability to choose what YOU want to do rather than what the insulin you took DEMANDS that you do.

Hi Carly,

I've been a diabetic for 32 years (am 34 now) and got the pump 6 weeks ago. Since then I've lost 6 kilos - it's much easier for me now to dose since I've always had problems with the long-acting insulin, I need varying background amounts during the day, and so I either had to correct or get lots of sugar into me, and on most days both. Exercise? Sure, but then again, lots of sugar.

A lot of people use the pump as an excuse for "oh just one more cookie". If you do that, you'll gain weight, but nobody gains weight just from being connected up. In fact, I'm using 25-50% less insulin now, and can finally eat as little as I should to lose weight

In fact, I'm using 25-50% less insulin now,

I am using 65% less insulin than before as well. And my A1C was 14+ the day I went live on my pump. I went live on Aug 27. I also had issues with my Lantus and either had to correct or eat more sugar. Just 3 weeks after going live my A1C was 8.6! Which is hard to believe with so much less insulin than before.

Only short acting insulin is used in the pump. However your long acting insulin is covered using a "basal rate". A basal rate is the amount of insulin you get every hour. What's great with the pump that you can't do with a long acting injection is change the rate at different times of the day. Right now, my basal rate is .5u per hour during the day. At midnight it automatically changes to .3 units per hour and at 3am until 8am it goes back up to .4 units an hour. I was struggling with lows during the night which is why the amount is lowered. Also, if you know you are going to be very active, say during exercise or like me when I take my kids to the zoo every week, you can use a temporary basal rate. For instance when I am going to the zoo with the kids I lower my basal rate to 90% of my normal rate a half hour before we go to the zoo, and then i cancel it a half hour after we get back from the zoo. That reduces the risk of going low due to the exercise from walking around. You can also make different profiles for weekends and weekdays (that you do have to manually switch to) because you may be more active or less active certain days of the week. Another thing that I am dealing with right now is being sick. When you are sick your sugars tend to run higher, so right now while I am sick I am able to set a profile up that I call *Sick* that increases my basal rate 120% of my normal rates. When I start to feel better or my before meal numbers are more stable than I can easily change it back to my normal profile. Another thing you can do that you can't with a long acting injection is take the pump off so that you don't have that basal rate going through you during low episodes. What I really like about my Tslim is what is called the IOB, Insulin on board. it's the insulin that you have already bolused due to correction of high sugars or eating carbs. My doctors and i figured out that my insulin usually lasts about 3 hours after injecting. So i can easily look at how much IOB I have after doing a sugar and see if I may end up going low or not. A lot of people are hindered by thinking that they will be connected by a tube all the time, but after you get your pump you will find that life is actually so much easier and normal. There is the option for the Omni Pod which is tubeless. A friend of mine has that one because she is a fish during the summer time and is in the pool for hours on end every day. So that was the best option for her since your pump IS NOT waterproof (it does come off during baths and showers). So that is also an option that you can look into. Another thing with the Tslim is that there are no batteries to change. Everytime I get into the shower I plug my tslim into the computer using a USB cable. Then every three days or so I upload all of the data from my pump onto my computer using the Tconnect software that is a web based software that tracks your information and shows you charts of your sugars, insulin usage, and stuff to help you find patterns of highs and lows. The only downside I have found to the Tslim is that as of right now there is no CGM associated with it, though there are talks that the DexCom G4 will be in the next year or so. Also with the software you can upload the information from your meter as well, there are several meters that are synched with the software. I hope that answers you question and gives you a little more insight and things to think about deciding if you want a pump or not.

Jenn

We had a "pre-pump meeting" with a Medtronic rep who showed some of the functions, then a day in a small group getting used to all the settings and attaching the pump, and then another half-day to catch up and see how everyone was doing or discuss problems.

This website is really good because it has carbs saved for most foods, too, so as long as you know what you're eating you can just enter it and it'll help you find the right dose. I also use an app on my phone, "carbs and cals", which is really useful if you're having a snack at a party or eating in a restaurant and can't weigh your food, it shows different portion sizes of spaghetti or chips or curries or cake etc etc on a plate so you can make a guess if you don't know the carbs for sure.

If you're worried about anything, try and get an appointment with a specialist nurse, I found the one who does the pumps at my clinic 1000 times more useful than any doctor I've met. She took the time to listen to my problems, suggested the pump and helped with any problems, and I can email her with questions rather than having to wait for an appointment.

Yes you will need to learn to count carbs, but meet with a dietitian or diabetes educator to learn that. You can get a lot of help that way and get set up with a good meal plan to stick with when you first start.

Pumps only use short acting insulin but deliver it 24 hours a day. You vary the amounts throughout the day based on your blood sugar levels and the history you have. Your doc will help set that up.

The CGMs are nice, however you still have to test your blood sugars with them. It decreases the amount to only about 3 times a day, but this keeps the sensor accurate. If your CGM registers you as low or high you also need to do a finger stick check for an accurate number and the CGM numbers have a delay to them, so your pump could have you at 70 when your really at 58, or read you at 200 and your really at 235. Just double check it with the finger stick and treat accordingly.