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Pump for a 58 year old

Discussion in 'Adults with Type 1' started by phil413, Jun 6, 2007.

  1. phil413

    phil413 Approved members

    Joined:
    Apr 26, 2007
    Messages:
    92
    Good morning all~

    My mother-in-law has had Type 1 for over 30 years. She is considering the pump now due to continual nighttime hypo episodes. I am looking for any encouragement/discouragement for whether or not she should do this.

    By the way, my daughter is a 7 year-old newly diagnosed Type 1. So, selfishly, I want my MIL to try the pump before we do. :eek:

    Also, she will be doing the Minimed with the CGMS if she does decide to go with the pump. That way she can be safe if she has to spend the night alone.

    Any thoughts are appreciated!!
     
  2. Jeff

    Jeff Founder, CWD

    Joined:
    Jun 1, 1995
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    1,546
    Every adult I know who has started a pump has had the same response:

    "I can't believe I waited so long."

    They all love it.
     
  3. rickst29

    rickst29 Approved members

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    Jun 2, 2006
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    I *STRONGLY* approve (LONG!)

    especially the use of CGMS as a "tactical weapon" against nighttime lows.

    Before I got a CGMS, we were going through 6-8 Glucagons per year. (DW is a M.D., I don't live alone.) In over a year since staring to use it --- Zero. Nada. None. ZILCH. The last stack we bought is sitting undisturbed in the meds storage drawer, quietly expiring. :D But more than with any other medical device, YMMV with the CGMS systems. I'm very lucky, my numbers are almost always right on. Most people are less lucky, but still find it worthwhile. And a significant number of people find that they're totally misleading, inaccurate, and useless-- they have to send them back for refunds. (And these people aren't using them incorrectly, their doing all the right things: their bodies just don't seem to be compatible.)
    - - - - -

    The pump is also of great value if it has been found that she needs different insulin rates at different hours of the night while sleeping. My rates, for example, start out at only 0.9 units/hour for the first few hours, but then increase, in 3 steps, all the way up to 1.8 units/hour just before I wake up. (I have a strong "dawn effect"). It is impossible to duplicate this action with bedtime are evening shots-- even the peaky "NPH" formulation is too strong at 3 AM, not strong enough at 7 AM.

    (Besides, Jeff, our Founder, calls NPH "Not Particularly Helpful"-- and in my case, he's right, the activity profile was very unreliable from one night to the next. Lots of hypo crashes AND lots of 250+ mornings, without any obvious reasons why I got one instead of the other. Other insulins just didn't come anything close to the 8-11 hour "peak" I needed. The pump handles my "dawn effect" perfectly.)

    But I do have one HARD question for you to consider: Why Minimed? The much more accurate Abbott Navigator has just been approved in Europe, so the wait for FDA approval here might be coming to an end. And also, the Dexcom current model has been found by many to be much quicker AND more reliable at catching hypos, for example:

    http://www.diabetesnet.com/forum/showthread.php?p=8

    My own Endo's experience with Mimined is much WORSE than even John's, while mine was pretty good. YMMV, but the general impression is: Dexcom is better, Navigator is WAY better. But now, on top of that, one of Dexcom's key studies to demonstrate the value, accuracy, and reliability of the new 7-day Sensor (which was just approved by the FDA) finds that it cut time spent "hypo" among the participants by FORTY PERCENT --- nearly DOUBLE the improvement a study conducted with nearly same protocol got when they tested the 3-days Sensor (approx 20% reduction in percentage of time spent Hypo). This is EXACTLY the problem which your MIL wants to address-- and the new Dexcom got twice the improvement as the current Dexcom, which in turn is felt by many to ALREADY be a lot better than the Minimed systems.

    The alarm volume on the Minimed pump-based system isn't loud enough to wake up a lot of people. (Although the new "Guardian" system alarm *is* loud, like the Dexcom, it's a similar separate pager-sized device-- two things to carry around instead of just one.) Some people dumped Minimed and kept Dexcom for this reason, even though their personal experience found accuracy comparable, and the convenience was much higher.
    - - - - -
    Lots of people get excellent results from Minimed too, much better than John Walsh did. YMMV! I recommend that she actually try both systems, at the same time, and see which works better/ is more convenient to use. Dexcom is far cheaper to buy (I hear on diabetescgms that they're offering the startup kit for the current 3-day Sensor at only $375, with an upgrade to the7-day for only $75 more when it's available), the current version isn't waterproof, and those "shower patch" water protectors are a horrible hassle. Join that message board, which is maybe 25% Dexcom users, 50% Minimed users, and 25% "still looking":
    http://health.groups.yahoo.com/group/diabetescgms/

    I think that proving medical necessity to get insurance coverage for your MIL's case will be easy, particularly if she chooses Dexcom with the "40% reduction in hypo time" study to back it up. :D
     
    Last edited: Jun 9, 2007
  4. DeniseS

    DeniseS Approved members

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    May 31, 2007
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    I have taken care of a pt who has had type 1 diabetes for 45 years who is on the pump and she loves it. I also had another pt who her sister has had Type 1 diabetes for over 40 years adn she told me going on the pump was the best thing she every did. My son is 5 and on the pump and he has had less episodes of hypoglycemia
     
  5. Caynuns mom

    Caynuns mom Approved members

    Joined:
    Apr 14, 2007
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    444
    Go For It!

    My Dad (T2 insulin dependant) had such uncontrollable bg for many years, he went on the pump about 7 years ago and he loves it. His bg has never been so stable in the almost 40 yrs of having diabetes.
    If My T1 son had insurance he would be on the pump also.
     
  6. DebK

    DebK Approved members

    Joined:
    Jul 4, 2007
    Messages:
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    Hi!

    I'm 53 and just started using a pump--the Minimed 722---in April. It took years to get me interested in using one, but when I found out about the cgms, I felt it was the right time. Unfortunately my insurance company isn't covering the cgms--yet--but hopefully will soon. I had a chance to "play" with the pump and read up on it before I was trained & started using it. My first reaction was "This is way too difficult." But, after I had the training I felt much better and got very comfortable with it very quickly. Now my response is the same as so many others "Why did I wait so long?" I did not have an opportunity to investigate any other pump, so I don't know what the others offer. The Minimed is easy to use and understand, but, again, I'm not familiar with any other. I think your mother-in-law will do just fine, but she needs to feel "ready" to use a pump. Good luck to her and to your daughter!
    DebK
     
  7. Richard157

    Richard157 Approved members

    Joined:
    Jul 19, 2007
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    Hello Phil! I have been a type 1 diabetic for 61 years and I started pumping on June 19. I waited so long because I already had good control before I started pumping and my doctor told me it was not necessary for me to pump. I went to an endocrinologist for a second opinion and she recommended pumping. I have adjusted to pumping quite easily, even though I am 67 years old. It gives me a much better lifestyle than injections did. I do not have to have such a rigid schedule as before. I can vary my schedule as much as I want without causing any problems. I rarely see highs or lows now that I have adjusted to pumping. My BGL's run 75-130 almost all the time. I have purposely programmed my pump so that I run 90-120 during the night. If I do go below that range at night it is in the 80's and that is not a problem.

    I recommend your MIL use a pump provided that she is motivated and capable of learning the details of pumping. It takes a lot of dedication and time but it is well worth it after the adjustment period has passed.

    Good luck to all of you!

    Richard
     
  8. corinne plywack

    corinne plywack New Member

    Joined:
    Aug 1, 2007
    Messages:
    1
    Insulin Pumps

    I have had my insulin pump, a Cozmo Deltic, for two years now. My endocronologist said he would not have necessarily put me on the pump, but when I inquired with my insurance company, they sent me one anyway. I was 57 years of age, and I have had diabetes since I was 21.

    My low blood sugars at night are far less than they used to be. I also find that I am more aware when the low blood sugars occur. I would recommend getting an insulin pump. I also thought that the transition would be difficult, but it was far less than I anticipated.
     
  9. Ali

    Ali Approved members

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    Aug 1, 2006
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    2,221
    I agree that for many of us long term type ones the pump is much easier. I am in my fifties also and went on the pump 4 years ago. I am abe to get much better control. I have always had strict eating and exercise routines but my BG values are just not stable or regular. The pump really helps! My best pre pump A1c were in the sevens, with all the insulin types and routines tried, and after going on the pump I dropped to the low sixes.
     

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