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Overall, how do you feel using an insulin pump affects your stress related to T1D management? (If you’ve used one in the past, reflect on that experience to answer the question.) Share more in the comments!
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It’s a tradeoff. The biggest plus for the pump is adjustable basal rates. Only way to Dawn phenomenon, bar getting up in the wee hours for a finger stick and a shot. And being able to reduce rates for exercise, or set higher rates for sick days, other issues. But mainly being able to reduce ’em. Because with MDI, your basal injection is non-negotiable once you’ve administered it.
The downside: it’s relatively complex vs MDI. WAY more failure points. Bad insertion sites, absorption issues, yank-outs, screw-ups when changing insets, mystery issues (is that a kinked canula or am I just running high for some other reason?) low-reservoir warnings jerking you awake, all kinds of stuff. Mostly I take these things in stride but sometimes I want to throw the thing against a wall. So yeah, can be stressful as well.
For me the advantages outweigh the disadvantages, but I can sympathize with people who find the balance tips the other way.
Now if you asked the same question about CGM it would be a MUCH simpler answer. They have their aggravations too, but the balance of hassle vs stress alleviation there is no contest at all. If for some reason it came to a choice I could sacrifice the pump far more easily than the CGM.
👍🏼
It’s not stress —it’s really the ease of insulin delivery. However, I totally agree with William Bennett in terms of a CGM—that’s where the major improvement occurred in management because you could see what was happening continually, 24 hours a day.
I am on the Omnipod 5 and the automatic insulin delivery system works great when it works, but I am finding that the Dexcom sensors start having issues around day 6 of the sensor session. This does affect my stress levels because I have to step outside (which frequently solves the problem), reboot my PDM (controller) or shut it down for 5 minutes, and or turn my phone on and off. The first couple of days on the new sensor are usually great, as stated earlier, on about day 6 I basically always have one of the devices in my hand. What am I going to do in the winter when I can’t just step outside? T1D is still a lot of work but it always has been. At least the new technologies and treatments for the disease have drastically improved over the years since I first got diagnosed.
I decreases. But really it is the CGM that decreases stress – the pump does neither
Yes, the CGM is important but I think the pump has reduced the stress of T1D a lot too – no more injecting in public before a meal or having to find a place for privacy. Also, being able to adjust basal rates throughout the day has been a game-changer. Yes, there are some hassles but overall the pump has reduced the stress.
I selected “Both increases and decreases my stress”, but perhaps an explanation would suffice here.
Using pump technology per se decreases my stress. As others have indicated, there’s no ‘stress’ about injecting in public; no ‘stress’ about finding somewhere ‘clean’ to inject; no ‘stress’ related to remembering which insulin to use (many type 1 diabetics, as I’m sure you’re all aware, use a basal insulin (long-acting) and an insulin for bolusing for meals (short-acting or rapid-acting). The ability to adjust doses and/or correction doses of insulin using a pump is phenomenal.
The creating more ‘stress’ relates to using CGM (continuous glucose monitoring). The number of alarms I receive is uncanny. If I get an alarm, say during the night, for a low glucose level I treat the said ‘low’, but my pump keeps alarming every 15 minutes or so, informing me that my blood glucose level is low and that I should retest and treat the said low. The algorhythm used in the current Medtronic/MiniMed pumps doesn’t take account that SOME diabetics might have a complication called gastroparesis, so corrective measures takes time before they have any effect. (In my case, it may take a 60 to 90 minutes before treatment has broken down and been absorbed into my bloodstream, and I’m hesitant to repeatedly use glucagon injections … these, too, take a while before glucose is released into my bloodstream. I’ve often been taken into hospital after I’ve received 2 glucagon injections as well as glucose injection directly into a vein as the paramedics have been concerned with how long things are taking to ‘happen’.)
Overall, I’d say that pump technology has been a game changer for me. It definitely beats multiple daily injections where you had to boil up a glass syringe in a saucepan prior to each injection, which I guess some of the older diabetics will remember. 😉
Oh my …. the alarms! I’m with you on that.
yes… this oldy remembers !!!
Back on MDI for two years. Hated having pump hanging off of me. Always had trouble with kinked cannulas and absorption. Really couldn’t wear a dress. Everything looks lumpy and how to you reach to dose. Traveling is less complicated. If you run out of supplies can get emergency insulin. Happy for now
And happy is what matters!!!
I use a pump w CGM guidance, Control IQ, after using pumps with no CGM control from 1982 to 2019 (used Basal IQ for 1-2 years before CIQ). Pumps decrease stress with improved control but CIQ greatly decreased stress with elimination or great reduction of night lows, and generally waking up w a good blood glucose in the morning.
The answers should include “neither.” When I used a pump, I felt fine, now that I’m not using a pump, I feel fine.
Using the Tandem pump with Control IQ reduces my emotional management load.
The last time I used injections was in 1992 when I had to rely on NPH, which was a complete nightmare with rigid mealtimes and horrible, crushing lows that came on suddenly from nowhere. I understand that MDI works much better these days due to scientific advances in the kinds of insulin that are available, but I’m quite content with my pump.
I’m glad to have the pump. Some stress with infusion sets/sites, cgm accuracy, other pump related issues. Still want to continue using the pump. I’m alive, feeling well and doing almost all things I want todo.
A little of both. Tandem control IQ and sleep mode greatly reduce stress. The alarms, battery charging, and unexpected set changes for test outs can sometimes increase stress. I wish I could program a “do not disturb” setting overnight on my pump for non urgent alarms like sensor will expire in 24 hrs” or “10 units left” (more than enough to cover me overnight).
I love the idea of an optional “do not disturb” alarm function for situations when you don’t need or want to hear an alarm beep. For me it’s when I am sitting in a silent group meditation with others and a damn alarm goes off and disturbs the inner quietude and sense of peaceful calm.
When the alarm sounds it disturbs the silence and triggers an emotional reaction response of embarrassment and dread as my mind shifts to focus on (1) disruption to others in the sitting group (2) wtf my BG is doing, and (3) having to look at the screen and make an adjustment to intervene if necessary. I try my best to make sure my BG is steady and safe in target range zone, however, it doesn’t work out that way.
Hence I have opted to take off my pump and leave it in another room far away from the meditation space so I don’t disturb and disrupt the inner peace within my self or others. When the meditation is over I reattach myself to the pump and continue with activities as usual.
This question is a “no brainer” for me. There is absolutely no doubt that having an insulin pump decreases the stress in my life, and has improved the quality of my life tremendously. Before the pump existed, I used multiple daily injections for 21 years, Regular and NPH insulins. My ability to function was limited, and my mental abilities were limited by constant, multiple daily very low blood glucoses. I lived in a fog for 21 years. As soon as I started on an insulin pump with Novolog, my mind cleared up, immediately! My life became more clear, controlled, and I could function with the rest of society on a more level playing field.
Like I said, this question is a “no brainer” for me.
Great !!!
Call me the zetetic diabetic, but . . . I do not think there is anything mechanical, electrical, hydraulic, or digital that can lessen the diabetic decision-making load. The rock of Gibraltar load is still there. More manageable? Sure. But the load persists and remains substantial. 🫤 🧩
That is why I decided NOT to use most of those things…
Decreases stress of highs & particularly lows !
Increases stress due to high level of data input to enable the lower stressed BG values
Increased stress: 1)Watching numbers all the time. 2)Alarms in public situations, theatres, meetings, 3) Loss of deep sleep, alarms at night for minor dips 4) sensor not working properly equaling bad numbers in bad numbers out, 5)still having to micromanage to achieve my own goals. 6) infusions sets with tubing getting hung up. 7) keeping so many supplies on hand including a back up plan 8)scar tissue which also was with shots but Tandem locations were limited.
Now on Omnipod 5 mostly manual 9) modifying choice of clothing to accommodate pump and sensor. 10) Having to keep up with the extra controller because pump doesn’t communicate with iOS (harder than one would think:) 11) manage sites to avoid compression lows which wake me up at night.
Decreased stress: 1)not having to pull out pens or needles in public 2) no tubing to get hung up on 3) more site availability for less scarring 4)can go on temp basal with exercise to prevent lows 5)can microbolus for corrections 6)ultimately can keep a tighter range and more in range 7) without tubing I can place the pump in a wide variety of places to avoid scarring 8) waterproof, so can bath and swim but still have to keep it out of hot water and avoid saunas and steam except for short periods. 9)Without tubing clothing is easier.
Overall, I am grateful for the technology of the pump and integrated CGM. I wish I could adjust the algorithms to fit my lifestyle and my goals more. If I had support I might try the do it yourself pumping but don’t have that yet so will just keep on manual for now with occasional switching to automatic when I am in situations where I can’t watch it. With a pump and CGM I can achieve my goals and in the long run, that is what counts.
OMG !!! My only problem 70 years ago was how to keep my candy dry while skin diveing in the ocean ….
This question invites people who haven’t had Diabetes very long to feel a sense of victimization, instead of focusing on the victories that come with managing this condition long term. Diagnosed in 1966, I didn’t have time to think about stress and depression. I had to focus on getting it taken care of and dealing with the fallout if there was an unexpected hospitalization.
1953 for me and it was just a part of life!!! I am treating it the same as then, now!!
Increases in stress are due to the Alerts!
And not being able to choose the alerts I want!
I certainly do not need to be alerted that my blood sugar registered high 2 hours ago!
What good is that????
Nor do I need to know that a bolus delivery was not completed!
I didn’t even attempt to bolus!!!
The pump has reduced my lows and highs even before cmg and not having to take shots five times a day is less as I am afraid of needles of all kinds
Both ways… it used to incrwase my anxiety until I learn to manage the alarms.
The most stressful part of the whole thing is still the infusion site when it’s not absorbing and the whole day goes to pieces. That’s where my stress comes from now a days.
I’m on the assumption I’ll be able to use a pump in the VA system, and on how it worked last year. I’m very comfortable with my care on insulin pens (a1C 5.3), but as of now I’m unable to adjust the basal/background doses but when pumping learned to decrease the basal dose or increase dosing utilizing the temp basal more aggressively than the Medtronic algorithm lets me. I “clicked” decreased stress because I can adjust the basal to counter decreasing levels rather than take in a specific number of carbs to prevent lows without going too high. Several complaints I read here were a lack of confidence in the CGM and alarms, the inconvenience of adjusting. I imagine how it was done as recent as 30-40 years ago, I feel lucky.
It’s a two sided coin. The pump, especially the CIQ app, has been a tremendous relief. In addition to coupling with the Dexcom CGM it does the math for me and is far more accurate than I am. The stress comes with the constant financial/insurance hassle and the knowledge that the pump is a machine that will eventually malfunction.
I have been on a pump since 1997 and I’m currently on tandem with control IQ. All of the annoyances which cause stress have been listed so far by others. Back when we only had urine tests and NPH and regular insulin perhaps there was less stress as, you didn’t really know what your blood sugar was and were only annoyed by it when you got one of those awful Lowes. Technology has certainly made administering insulin without the use of syringes very very convenient. I feel that all of the annoyances are the price we have to pay to have the superb control that can now be achieved compared to what it was , 40 50 and 60 years ago. I certainly get much better sleep with control IQ sleep mode which consistently keeps my blood sugars good during the night and allows me to wake up with good numbers. also, just knowing what my blood sugar is dramatically reduces stress as long as the sensor is working properly, which is not always the case. Then I get very stressed and frantic, having to rely on fingersticks sometimes at inconvenient times. so I answered both more and less stress based on the particular aspect that you are looking at. I don’t feel that overall Pumps have dramatically decreased the burden of diabetes, but just allow us to have much better blood glucose control.
On another note, I can imagine that automated insulin delivery systems dramatically reduce stress for parents, having to take care of children with diabetes as they no longer would have to be constantly poking their child, and would be able to monitor their blood sugars remotely.
I quit my insulin pump therapy for about 6 months one year. First A1C was not too bad. Second one and I went back to the pump.
When things are under control and the pump is not constantly alarming stress is low. Unfortunately I have had multiple occlusion alarms recently and am very frustrated. I have done all the suggested interventions to no avail. Running out of insulin and supplies because I am having to change the site so much. Tandem appears reluctant to offer loaner pump to see if that is the issue.
M
The stress overall is less, but the one thing I didn’t see in other comments was working around timing of replacing infusion set and resivor. Trying to make sure I take enough supplies when I travel and not wastig cartridges and infusion sets. It has been chalanging to get enough supplies to cover 3 monts for medicare regulated orders. I had to get my Endo to write 3 Rx to get to 4 boxes per order. It seems to be working now. We’ll see at how many I have left at the end of July.
A SOLELY private matter now becomes severely public and draw both entirely unwelcome and entirely unwanted attention. Had I know then how much noise the machine(s) made I would never have submitted to them for any reason. My condition is my concern alone, and every time it give off an unwelcome sound, or an alarm, it becomes severely problemative, hard stop!
Insulin pump, by itself, reduced my T1D management stress. With the addition of CGM and BS alerts, the stress dealing with the time required and frustration with all the alarms. The CGM/Pump though has increased my control so much I have to say stress of managing T1D has reduced more than increased. Menopause and stress has stressed me the most in controlling my BG (random, rapid changes to BG for no apparent reason).