Why I declined the Medtronic 640 pump

Since I was diagnosed at 11 years old, the pump has always been put up on a pedestal. Only the very fortunate get access to this magnificent piece of technology, after endless years of wait. I was put on the waiting list on day one and after twelve long years, my time had finally come. No more injections!!! No more raised eyebrows as I shoot up in public!!! SUGAR LEVEL CONTROL!!! Considering I have an entire diabetes-focussed website, my control has always been fairly regulated. However, this improvement in technology will allow me even more control. I had done my carbohydrate counting training and there I was in the cramped doctor’s room, opening the cardboard box that held my brand new Medtronic 640. It was just as I had seen in the multiple Instagram pictures online. Smaller in size than a phone, but chunky, quite chunky, in fact. Not to worry, the advance in technology is worth the bit of width.

The machine itself is quite straightforward. I certainly didn’t need a two hour training to go through the menu options, but the other seventy year old diabetic who I was sharing the training with was less tech-savvy, fair enough. There’s no doubt that the pump makes taking insulin a whole lot easier. For example, high-carb foods like pizza take a longer time for your stomach to digest. Because the carbohydrate digestion takes longer than the insulin absorption, you might find that after the meal you’ll have a hypo, followed by an intense sugar spike (click here for more info on this). There’s a solution for this on the pump, called a dual-wave bolus. It spreads out your insulin over multiple hours to cover the entire food-digestion process. Having said this, you can actually do this with injections too. I simply inject half of my dose before the pizza, and the other half two hours afterwards.

Another handy option on this pump is the temp basal. In other words, you can reduce your insulin at times when you might find yourself more sensitive to it, such as during or after exercise. This is certainly more convenient than eating extra food in the evenings after a gym-session even when you aren’t hungry or having to wait two hours after taking your last shot before going for a run. What I will say about this though is that you can’t set a time for this insulin to be reduced. For example, I was looking forward to setting a temp basal on the mornings after a night out. After I’ve had a few drinks I often find myself going low in the morning once my liver starts working on removing the alcohol from my system rather than releasing glucose (read more about this here). You cannot plan a time for a temp basal on this machine, you can only reduce it by a certain amount of hours.

There’s many other perks to the pump, and there are certainly many reasons that it’s so highly commended. However, once the time came to apply the test pump, my excitement started to diminish. The application involves tubes, adhesives, cannulas and reservoirs, which need to be reapplied every 2-3 days. Once I had the process complete and I sat there with it attached to me, I felt a mixture of upset, silly, and guilty. I felt silly and guilty for feeling upset, as I knew that so many people would love to be in the position I found myself in. I felt upset because I instinctively knew this machine wasn’t for me. Determined as ever, I said I would try it out for a week at least, but only ended up lasting the day before freeing myself.

For me, managing my diabetes is currently a simple process. Sure, I have the occasional high and low, but overall I have a relatively good control that multiple daily injections helps me to secure. Changing to the pump would simply be complicating a process that I have become very used to and upon reflection, I am happy with! Perhaps it is due to having diabetes since I was young, but I have absolutely no issue with jabbing myself at every meal. I am more comfortable with taking an insulin shot and putting it away until the next one is required than having a machine attached to me at all times. The pump brings with it so many success stories of improved diabetes control, but I am currently happy with my injections so will continue with these until that may change in the future! I'm not trying to convince anybody to avoid the pump. If you're given the opportunity, definitely try it out! However, use this as a reminder that everyone manages their diabetes in different ways, so make sure to do what feels right for you.

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