I am 52 years old, in menopause, I have been on the insulin pump for four years, the pump has afforded me freedom, but I have never gotten the kind of control I had hoped for because I have brittle diabetes. For the last month, I have had a lot of problems with the pump (which may need to be replaced), very unexplained high blood sugars, problems bolusing enough to cover carbs since I have to guess frequently, and now I may be having problems using my abdomen as a site. I’ve been told to try my leg, which I hate. I can feel it; it gets pulled out by pants rubbing, etc., and I just plain don’t want to use my leg. I also have gained weight that will not come off since using the pump.

Should I go off the pump? Since I am used to close monitoring, I could go back on injections, possibly lose some weight and have less stress that I have been experiencing of late. The only real benefit the pump has given me was the freedom of eating meals late, or skipping them and not having to pull out a syringe. I don’t know if that is enough to justify staying on it and arguing for an upgrade of pumps with my insurance company.

You have already convinced me you don’t want to be on the insulin pump, and I believe you. There is not any information out there that says that is a bad choice. In fact, as long as you keep a similar ahemoglobin A1c, there is not a lot of difference. The biggest issue is freedom of choice. Please speak with your physician and diabetes care team about this. They need to hear your feelings about this.

JTL

[Editor’s comment: You sound extremely frustrated, and I agree that you need to express these concerns with your diabetes team. However, before you make your decision, please keep in mind that the term “brittle diabetes is not used anymore for very good reason. With the availability of newer insulins, basal/bolus regimens, and the pump, it should be possible to adequately control your diabetes, regardless of whether you choose to continue with your pump or go back to injections.

It seems to me that you are most likely lacking in the appropriate amount and kind of education to use any of these treatment regimens to their fullest advantage. You need in-depth diabetes educations to utilize these sophisticated methods if you wish to achieve tight control. Please schedule a conference with your diabetes to review your knowledge and skills as soon as possible. An insulin pump is only another method of insulin delivery, it is not a substitute for your own knowledge, skills, and attitudes.

SS]

[Editor’s comment: There are numerous stories of people taking a “pump vacation” using a combination of mealtime insulin analogs and once-daily Lantus (insulin glargine). See Taking a Pump Vacation.

WWQ]