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November 19, 2007

Daily Care, Other

Question from Washingtonville, New York, USA:

I was diagnosed with type 1 diabetes on November 12, 2007. I am still in shock about getting diabetes. I'm freaked out about having to give myself injections. How long before I can get a pump?

Answer:

This is not just an easy question to answer. You need to discuss the pros and cons of pump therapy in good detail with your diabetes team. When (and if) an insulin pump is right for you hinges on many, many things especially including your ability and willingness to be “hooked up” to a small device virtually all the time. You also must be very good and skilled about counting your carbohydrates and have good math skills so that you know how much extra insulin for the amount of calories eaten; therefore, you have to program the pump manually to give insulin during meals. (The pump doesn’t “know” what you’ve eaten or when you are exercising.)

I generally recommend that a person with type 1 diabetes has to be on an insulin plan with long-acting insulin (as the “baseline”) plus rapid-acting insulin (the “bolus” or mealtime) WITH SUCCESS for a minimum of six months before considering an insulin pump. But, the tone of your letter suggests that you have more important hurdles to overcome. While insulin pump therapy is a wonderful way to give insulin, it is HARDER than injections. Pump therapy still requires that you check your blood glucose several times a day. If the pump is not working right or things get out of balance, you STILL have to give shots periodically. In other words, an insulin pump IS NOT AN ARTIFICIAL, MECHANICAL PANCREAS. If you still are “shocked” and “freaked out,” then you need some more sessions with your diabetes team, especially a “Certified Diabetes Educator,” before I would recommend an insulin pump.

DS