5 Reasons I Don’t Use an Insulin Pump
I get it all the time: “What? Why don’t you use an insulin pump?”
It blows people’s minds that I would choose multiple daily injections (and now, inhalations) over wearing an insulin pump that sits in my skin 24/7.
For many people, an insulin pump offers freedom, flexibility, less stress and better blood sugars. Not for me. Not even during two pregnancies!
I’ve lived with type 1 diabetes (T1D) for 23 years, and I’ve used an insulin pump exclusively for at least seven of those years. The last time I tried to go back to pumping—giving the ol’ tubeless pump a try—I quit within weeks.
I’ve figured out how to make multiple daily injections (MDI) work for me in a way that allows me to achieve my blood sugar goals, be very physically active, eat a flexible diet and show my diabetes who’s boss on a daily basis.
Here’s why I don’t use an insulin pump.
My A1c doesn’t care…
Actually, my A1c is significantly lower now than when I used a pump, but this is because of my age, not my method of insulin delivery. In my late teens and early 20s, my A1c was in the high 6s to low 7s. Today, I maintain an A1c in the highs 5s to low 6s—and that’s my target A1c range.
In the past 15 years, I’ve devoted a great deal of my energy to learning how to manage tighter blood sugar levels regardless of how I get my insulin. Yes, using a continuous glucose monitor (CGM) had a huge role in this!
But the technology alone does not improve your A1c. Whether I’m on a pump or taking insulin via injection/inhalation, I still have to put in the effort, make thoughtful choices around food, manage the impact of daily exercise and check my blood sugar throughout the day to juggle the many other factors that impact diabetes.
Certainly, today’s closed-loop pumps can be a game-changer for those who appreciate that type of support. For me, wearing an insulin-delivery device in my skin 24/7 creates more stress and reduces my overall feeling of freedom in life with T1D.
I hate wearing a pump—and my skin hates it, too.
Is “diabetes technology claustrophobia” a thing? For me, it definitely is. Quite simply, I feel trapped.
I don’t mind wearing a CGM in my skin—it’s much simpler. It’s not pushing anything into my skin, which means the impact it has on my skin is significantly lighter. And if it fails suddenly or gets pulled out accidentally, it’s really not a big deal or urgent issue. Yes, I need to replace it but when an insulin pump fails, it’s a very urgent issue.
I also hate having to wear an insulin pump on my belt or in my pocket. I hate having to deal with it during showers or sex or exercise. Ugh, or sleep. (Don’t mess with my sleep!)
Also, I have really sensitive skin. My skin simply hates receiving a constant infusion of insulin.
Pump site failures stress me out.
I find it really stressful how quickly you can develop moderate ketones or simply blood sugars over 300 mg/dL just because a pump site failed or there’s a kink in the cannula.
Using long-acting insulin for my background/basal insulin needs means I never have to worry about this—ever. Sure, there are other reasons, like a terrible stomach virus or extreme stress, that can lead to ketones or an huge unexpected spike in my blood sugar, but those are rare.
With an insulin pump, site failures are par for the course. They’re expected. They’re one of the things you simply have to deal with in order to get other benefits of pumping.
As a mother of two, I also find it extremely stressful to be worrying about a 300 mg/dL because the insulin isn’t getting through a new infusion site properly than simply taking my insulin via multiple daily injection (MDI) and knowing without a doubt that I’m getting what I need.
I don’t want to deal with site failures. I’d take the stressors of MDI over pump site failures any day, all day.
Pumps are expensive.
For many years in my early-to-mid 20s, I had zero health insurance. Paying for monthly insulin pump supplies out-of-pocket would’ve been impossible. Those years of being without health insurance also made me pretty thrifty when it comes to diabetes management! It’s hard to shake that feeling of never knowing if you’ll be able to get what you need, when you need it.
Today, I have wonderful health insurance through my employer, but the cost of using an insulin pump would still be significantly more than MDI.
I appreciate the simplicity of MDI. If I can achieve my blood sugar goals at a lower cost, I’m going, too. (This thrifty mentality is the same reason I look for my boyfriend’s oat bran at the Vermont Liquidation Center before buying it at the grocery store! I like saving money.)
MDI supports my personal lifestyle and discipline goals.
With an insulin pump, you can press a few buttons at any moment and take a microdose of insulin to cover the mini-chocolate bar you just impulsively ate when you trotted through the kitchen.
I appreciate that I cannot do that as easily on MDI. While I have figured out how to take teeny micro-doses of injected rapid-acting insulin, it’s still much harder to cover 8 grams of carbs.
I appreciate that I need to be intentional with my meals, when I exercise, and how much I eat. I appreciate that MDI forces me to be thoughtful with these decisions if I want to keep my blood sugars in my goal range.
The bottom line…
It’s a good thing we have choices, because what works for me and feels like freedom to me isn’t going to be what works for everyone else. That’s okay! Yahoo—we get to choose! And you might even go through a temporary phase of life where MDI works better for you than pumping, or vice-versa.
We need choices. I’m grateful these insulin pumps exist, but I don’t want to use one. I’m grateful I have that choice.