Back on shots after pumping?

I'm thinking of trying shots again after being on an insulin pump for two years. I miss the rigidity of shots.

After 20 years of injections, I thought I'd never want to see another syringe (or pen) again. The biggest benefit of the pump has been the ability to adjust my basal rate during exercise.

But I think shots could potentially help me have better control of my eating habits (I think I've enjoyed the "freedom" a bit much). I know it would be an adjustment and wonder if anyone feels the same way about wanting a stricter lifestyle back; I feel a little silly admitting that and wonder if I'm the only one with diabetes who feels this way.

I haven't yet talked to my endo about the adjustment but will see her later this month.

▶ Reply to This

Replies to This Discussion

Permalink Reply by Kevin on March 16, 2008 at 3:30am: I suppose I am concerned about the backlash of my reply, however I feel the same. I frequent the Starbucks drive-thru and just bolus away carelessly. When I was on multiple daily injections, my glucometer would be the first thing I reached for. Do you ever wish you could just have a week or so away from being attached to this piece of equipment? Also, it seems when things are going good, it's great. The flip side is that when things go bad, it's bad in a hurry. Please post again, I am interested with what you come up with.; ▶ Reply to This

Permalink Reply by drrps3 on March 16, 2008 at 6:00am: I was glad to see this post. Even though I have never been on a pump, I sometimes feel very pressured by family, friends, some doctors to go on the pump. I can tell you it's not for me, and for the most part I do OK with my shots. I guess I do feel it's more structured in that I do watch what I eat more so than a couple of family members on the pump. That's just in my experience as I am sure there are many pumpers who are very structured. I think you should go back to the shots for a trial period then see what works for you right now. Good luck!; ▶ Reply to This

Permalink Reply by Jenny on March 16, 2008 at 8:38am: Aliya,

I'm not on a pump, but last fall I moved from using R to using a Novolog pen, which meant that instead of having to wait an hour after injecting before I ate, I could whip out the pen and inject any time I wanted some carbs. My blood sugars were great, but I packed on a bunch of weight after years of not gaining. Some of it was because I wasn't taking metformin any more, but some of it was because I could eat starchy and sugary stuff on impulse.

So it makes sense to me that having a pump would make it easier to eat without restraint. OTOH, you could argue that the pump just gives you the choices open to a normal person and that the real solution is to train yourself to have some dietary self control which is what normal people have to do as they get older.

I dealt with my problem by doing 6 weeks of an extremely restrictive diet (22 g a day of carbs) to kind of "reset" my system, and now I'm only letting myself use insulin in a more restrictive pattern, though I'm still using the pen.; ▶ Reply to This

Permalink Reply by Dee Meloche on March 16, 2008 at 11:33am: I thought I was going to change my eating habits after pumping but it has been too many years since I have injected insulin and my stomach is not able to handle eating extra foods or eating sweets.I basically have a piece of apple pie at supper or the odd piece of birthday cake.Other than that I am still eating my no sugar no salt added puffed wheat for breakfast.The pump only gives me better control it doesn't allow me to eat more.I don't even have the taste for anything sweet.; ▶ Reply to This

Permalink Reply by Brian on September 15, 2008 at 10:49am: I was on a pump for four years. My doc suggested I take a break from it to let me scar tissue recover and try lantus. I've been off the pump for a few years now and really like it better. It was actually quite liberating to ditch the pump and not have a device constantly hanging off of me plus i really like lantus feel. I only do one shot of Lantus a day in the morning so managing my morning BG can be a little tricky. Having said all of that, I will probably go back to a pump some day when closed loop artificial pancreas technology becomes available.; ▶ Reply to This

Permalink Reply by Cathy on September 15, 2008 at 10:54am: since i have never been on a pump I cannot understand how that might feel . I have always done mdis . ever since being diagnosed . I like the freedom that the mdis give me and I can go swimming anytime I want and not have to worry about detaching something from me . I have never even considered a pump because of the cost and of course my endo is always trying to get me on one . I keep telling her I dont like the idea and my not having insurance plays a big part into that . Oh well whatever you decide please keep us updated . good luck as well .; ▶ Reply to This

Permalink Reply by debb on September 15, 2008 at 11:33am: i'm not a pumper either. i'm t-2. but from what i have read on these discussions and blogs, it seems to be the consensus that you should do what feels right for you. it's your diabetes and it comes down to what you want, not what others want. btw....what did you decide to do?; ▶ Reply to This

Permalink Reply by cdw on September 15, 2008 at 11:40am: Seems to me that you want to use your pump as an excuse for your lack of self control. You can manage your diabetes much better with a pump all you need to do is learn self control.; ▶ Reply to This

Permalink Reply by Cody Turner on September 15, 2008 at 11:41am: I was on mdi's for about 5 years and been on a pump since April of this year. I can't even imagine going back to shots, but I can also understand your reasoning for doing it. I have so much better control since I got the pump. But then again I was also diagnosed as a brittle diabetic so mdi's was hard for me to achieve the control I have with the pump. I was up to 8 shots a day on mdi's on a good day.; ▶ Reply to This

Permalink Reply by Michelle on September 15, 2008 at 12:49pm: Aliya, this was originally posted in March and I am just now reading this... Did you end up sticking to the pump or go back to shots?

This is my experience: I was on the pump for some years and then heard about the pens and thought they were so similar to the pump (injecting fast insulin when you eat) and cheaper, I switched back to shots.

The pros are:
1. Not being attached to the pump.
2. Supplies are cheaper (actually, I've never calculated this so this may or may not be true).

The cons are:
1. Figuring out how much Lantus to take. This has taken about two years.
2. Having to take more Novolog during the morning and evening (this also took 2 years to figure out the correct amounts) since Lantus doesn't allow basal rate adjustment. This has been the most difficult and has been hard for me to get used to taking different amounts of insulin per carb depending on the time of day.
3. I have lots of scar tissue because of the multiple injections through the day, my belly hurts, and the Lantus injection gives a weird achy tingly pain a few minutes later (when it's crystallizing I guess).
4. It is hard to take a shot at someone's dinner table or when you are out to eat, but it is a lot easier to put in a bolus from a pump without anyone noticing. I find that I wait too long to take my shots sometimes.
5. At first I forgot my insulin at home sometimes since it wasn't ATTACHED to me anymore (I'm an airhead). But also, I have to cut evenings short sometimes because I need to go back home and take my Lantus dose at a certain time of night.
6. I got so used to eating like a normal person and being able to snack and nibble all day. I know that sounds unhealthy, but I feel as though that is how my body prefers to digest things. I really miss being able to do that. I lack willpower in this area and still snack, which means more shots or the occasional forgotten shot.
7. I need to visit the pharmacy twice a month instead of once a month, I kind of miss having the supplies for the pump getting dropped off at my door every few months.
8. I had much much tighter control on the pump.

Since I've waited so long to get back onto the pump, it is going to be expensive, but it is my goal to get back on. Also, I know there have been a lot of kinks with the CGMs, but I would like to get on that eventually. My father is on it and he says all of his complications went away and he doesn't have to wear glasses any more.; ▶ Reply to This

Permalink Reply by Dino on September 15, 2008 at 2:03pm: I like shots. I feel just like Aliya when it comes to rigidity, only I never tried the pump.

I like being strict on myself. Every day becomes more predictable. For the most part, food just represents fuel...not a treat or not a flavor indulgence. Don't get me wrong, I love a good meal, and I'm not on a 100% robo-diabetic meal plan. But I no longer cruise into a fast food drive-thru whenver I feel like a chocolate shake...thinking I can just cover it with insulin and that will be that. That is not how my diabetes works anymore.

I also noticed that when I talk to some pumpers (keyword some) they talk eagerly about flexibility when it comes to diet. "I can eat whatever and whenever I want...I just need to cover it with a bolus." It's like a badge of honor when they show people..."hey look at me, I'm eating an entire apple pie and all I have to do is take this bolus of 278 units of Humalog and my blood sugar is still normal an hour later. Yaay for me!"

That's a nice concept but really the question is...what exactly are the foods that you want to eat?...and most importantly, why exactly do you want to eat the foods that you choose?

Many T1 diabetics believe that the pinnacle or "dream" of perfect control is the ability to eat and live like the majority of non-diabetics yet still maintain good blood sugar, cholesterol, weight, etc. Many also believe that the pump is the best/ only way to achieve this. The worst part...many endos and dieticians reinforce this questionable philosophy when guiding us through the options of treatment.

Not a bad concept on the surface, but I think that we need to stop "wanting" to be like the non-diabetic people that we are not...even at the most assumptive and subliminal level. Their lives are not better than ours just because they can eat whatever they want. More importantly, our lives will not improve if we keep trying to prove to ourselves that we can eat anything we want and just cover it with insulin. Insulin therapy is not the end all be all cure for diabetes...therefore, the pump as an easier, more flexible method of insulin administration does not necessarily mean a better form of control over MDI's. Only different.

To me, the real dream of perfect control is achieved first by embracing your diabetes for what it is and then no longer looking at the diabetic-lifestyle as a "curse" or a "sacrifice." Better to focus more on how to live happily as a 100% diabetic than to try to be what we are not. Soon you will realize that hidden within this "curse" is a potential blessing of good nutrition, physical fitness, and overall well-being.

As far as pump vs. shots...heck I don't mind taking shots. I'll take shots all day long if I have to. Flossing in between my molars is more of a tedious hassle to me than taking my shots.

Just don't attach that pump onto me, dammit *(just my opinion). I know it's fancy, I know it's awesome...but I'll just take my shot and move along, thanks. I have my reasons.; ▶ Reply to This

Permalink Reply by Terrie8 on September 15, 2008 at 4:10pm: Well said Dino. I agree. Plus self-discipline doesn't hurt and is empowering. I think you just made my decision about whether I should get that pump or not. Thanks! :o)

I hope that you are doing Well Aliya and Good Luck on your decision.; ▶ Reply to This