December 3, 2004
Blood Tests and Insulin Injections
Question from Mannheim, Germany:
Are there any recommended guidelines on stopping insulin pump therapy? How popular is this option? I initially went on a pump while in graduate school/working full time. Due to my erratic schedule leading to erratic blood sugars, my doctor thought the pump was an ideal solution. I have now been on it for five years and I find that I have lots of problems with bad infusion sites and this is leading to erratic blood sugars. This is not really helping my blood sugars as designed.
My A1cs are usually in the 7 to 8 range, but before graduate school, when I took multiple daily injections, I had A1cs in the 5.5 range. When I was on daily injections, I was much more disciplined, but the “freedom” of the pump and the infusion site problems are not keeping my blood sugars down as they should be. My doctor recently suggested that I combine some Lantus shots with my pump therapy, but I would prefer to stop it all together. Is there anything I need to be aware of?
Answer:
This is an option that occasionally comes up in people treated with subcutaneous insulin pump therapy. Some indicate they have a form of burnout. Others do not like the idea of the pump hanging from them. Others are tired of dealing with the mechanical device. In some situations, a “pump vacation” is a reasonable change of pace. In any event, it is not rare. How you do after you stop the pump may have a lot to do with whether you return to it. Many people take a pump vacation only to come back to the pump. Some do not return. You should talk to your physician about a safe way to transition yourself to intermittent injections. There is no study that shows you have to be on a pump to get good control. Most people feel the flexibility is still maximized with a pump. You probably need to answer this for yourself. After all, you are the director of your treatment. Only after being off it for a while will you really know which one is best for you.
JTL
