A veteran diabetic and diabetes coach has started wearing a new insulin pump after taking injections for more than 40 years. Today I will share with you Melissa’s story through a recent conversation I was able to have with her on her podcast.
Do you or someone you know wear an insulin pump? Or do they take manual daily injections to manage their blood sugar levels? Different people do different things to take their insulin doses. And there are several insulin therapy options available, including multiple kinds of pumps for the management of type 1 diabetes.
New Insulin Pump
Although new insulin pump technology has been around and improving for a few decades now, many people with diabetes continue to take multiple daily injections (MDI) for various reasons.
I write in my book about how I am just so thankful. Not only for the diabetes technology, but for the choice in diabetes management for this chronic disease. Having options allows for a greater quality of life with chronic diseases. It wasn’t always that way, and diabetes coach Melissa Slemp can remember those days from her diagnosis 40+ years ago.
Let’s use her diagnosis as a starting point for our conversation below. And then we will get into her change to wearing a new insulin pump.
Diabetes Diagnosis
Q: Remind us a bit about your diagnosis… when were you diagnosed, and what was your treatment?
A: I was diagnosed with type 1 in 1982 at 14 years of age. I used vials of pork/beef insulin drawn into disposable syringes at the time. I did not have access to a glucometer in the early days, based on lack of availability. So I used urine sticks to gauge my blood sugar levels. I was not well managed in those days, but it was all I knew and had access to at the time.
Q: How long were you on multiple daily injections (MDI)? What meds did you take?
A: I have been on MDI since day one. Daily injections have been my life since diagnosis at 14 years old. In 1982, I started out with vials and syringes, using pork and beef insulin. For my last MDI therapy, I used the smart insulin pen called the InPen. I took Novolog as a quick-acting bolus insulin and Tresiba as my long-acting basal insulin.
40 Years on MDI before a new insulin pump
Q: What was your experience like on MDI?
A: Overall, I had a great MDI experience. But that was easy to do when it’s all I knew since day 1. Over time with different insulins, my numbers improved and I felt more secure with Tresiba, for example, which always had a steady coverage for me. I had no peak times of release, and this was a blessing compared to previous basal insulins. Those led to many scary episodes of low blood sugar, especially overnight and early morning.
What I liked about MDI are the same reasons I kind of miss it. I liked using the smart insulin pens. It worked a lot like a pump, giving me time in range and doses in ½ units. I could input carb counts and it was synced with my CGM readings.
Q: Did you ever consider something other than MDI over the years?
A: I avoided a pump based on feeling comfortable with my routine of carrying insulin and injecting as needed. My A1c and glucose values reflected this, which was my motivator not to consider a pump but keep going with MDI.
Exploring New Insulin Pump Options
Q: If you were doing so well on MDI, what started the thought of exploring pump options?
A: Talking more with my clients in the diabetes community about their experience and interviewing a pump trainer on my podcast was what got me thinking about it. This really helped to fill in that missing piece of understanding all the benefits. Then I was open to learning more and considering trying it out. It piqued my curiosity and calmed my nerves about switching over.
Q: What kind of things did you find in your pump research?
A: Going in, I knew I wanted a tubeless pump. So that narrowed my research down to the Omnipod 5. I met a rep from the company at a Touched by Type 1 convention and I was able to see the product and ask questions. I also spent time on their website and talked with others wearing this model of pump.
Q: How was your endocrinologist / healthcare team involved in this process?
A: I am a new patient with my endocrinologist, so my pump trainer was in contact with her to get my insulin:carb ratio and basal rate settings to get started with insulin doses in the new insulin pump. I will see my endocrinologist in a few weeks for the first time since starting on the new insulin pump.
The Challenges of Starting a New Insulin Pump
Q: Your husband also has type 1. Did he remain on MDI, or how did that work?
A: Both Dave and I decided to try the Omnipod 5, so we met with the pump trainer together. He had been on a pump many years ago. Back then, he was on a different model, so the tubeless pump was something different for him this time.
Q: What was the biggest hurdle you faced in the transition to your new insulin pump?
A: Letting go of control was for sure the biggest hurdle. I had always been the one to decide insulin dosages, but now I had an automated system stepping in to help. (Tandem calls this Control-IQ technology. Minimed calls this a closed-loop system. It’s technology that basically tries to help prevent both low and high blood sugar for better glucose control.)
It took time and patience while adjusting my settings and for the algorithm to learn me and my routine with food, exercise, and other factors that affect blood sugar.
Q: What is the biggest difference between MDI and an insulin pump for you?
A: Wearing my insulin instead of carrying my Inpen in my purse is huge. Wearing my new insulin pump is actually very convenient on the go. I no longer have to worry about temperature control with my insulin pen and storing it properly while I’m out.
One downside of the Omnipod system is that it requires a separate controller, which is something else to carry. It’s kind of like having a second phone.
The Experience of Wearing a New Insulin Pump
Q: How long have you been on a pump now? And what has your experience been?
A: I started about two months ago. Overall, I’m feeling very confident and comfortable wearing it. Also, with the tweaks I’ve made in my settings, my time in range continues to get better and better.
Q: What would you recommend to someone considering a change from one treatment to another?
A: I would suggest you seek our diabetes community and talk with others who are wearing a system you’re interested in. Visit the manufacturer’s website. Your endocrinologist’s office may have diabetes educators and pump trainers available, so don’t be afraid to ask questions. Make the best decision based on your unique needs, and also weigh the pros and cons of each device you’re considering. Trust your decision, pray and be willing to take a step, knowing that you can change your mind if it isn’t working.
Types of Insulin Pump
While Melissa chooses to wear an Omnipod 5 insulin pump, I wear a Tandem T:Slim (although the Tandem Mobi insulin pump – the world’s smallest durable insulin delivery system – is their newest offering). Both of these pumps coordinate with the Dexcom G 7 CGM we both wear, and both pumps have a mobile app. There’s also a Medtronic Diabetes (formerly Medtronic Minimed) insulin pump and compatible CGM system on the market.
All three pumps have unique features, but each are an automated insulin delivery system with FDA approval in the United States. The Tandem and Medtronic pumps are both tubed pumps, while the Omnipod is all contained without a visible tube.
But all three are basically an infusion set (that you switch out every few days). When you insert a new “set,” a small canula sits just under the skin for the subcutaneous delivery of insulin.
If you’re considering various automated insulin delivery systems, contact your healthcare provider. They can help you understand more information on your next step and what might be the best option for you.
Melissa is a wife and mom who has been living with type 1 diabetes for 40+ years. She is a certified health coach and personal trainer, and owner of Abundant Health with Melissa, helping busy women overcome obstacles and emotions managing diabetes. Melissa has navigated menopause, an empty nest, and life’s curve balls. She runs two thriving businesses, all while reaching her own health goals.
If you would like to connect with Melissa, you can visit her website at abundanthealthwithmelissa.com.
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