Prons and cons of using an Insulin Pump?

I think for me there's a lot more pros than cons but sometimes you know a pro can lead to a con and I remember taking part in a clinical trial back in 1981 and for an insulin pump and the pump that I was issued with was the size of a brick. It wasn't the most discreet item but you know it was a start and it was an interesting experience but now with the the pumps that are available commercially they are a lot more discreet. You don't have to have them as a kind of label that you wear obviously to say, oh yes, I am diabetic. You can sort of put them, or as I do, put them in my pocket and try and keep them out of the way so people don't need to know. And that's a huge advantage because when you're in a restaurant, you're not running off to the loo to have an injection or you're not injecting yourself in full view of other people because that causes some strange reaction. Well, they're not that strange, but they cause reactions. It's not what any Westbrook goer necessarily wants to see. So for me, I've had a tandem, I'm now on the tandem pump with Dexcom continuous glucose monitoring. And I trust the Dexcom system. I've monitored it alongside normal blood glucose measurements and I trust it to say the right thing. It's got the right level of sophistication kind of meet that need. I was previously on a Medtronic pump which I feel wasn't as good and I've also taken part in a clinical trial with Cellnova and that was an interesting exercise because we were looking at continuous glucose monitoring and also monitoring exercise so that it was dealing with that triangle as it were in a much more scientific way than I ever had. and sadly Selmova is no longer. They went into liquidation unfortunately. But anyway, pros of pumping. It's like the equivalent of one injection every three days. You're not having to have an injection prior to each meal or having maybe four injections a day. That's the pro. The con is that you are attached to a machine for 24 hours a day or you can take it off for a couple of hours without it having any adverse effect in most circumstances. I'm okay with it because frankly having been attached to a brick for the period of this clinical trial being attached to a much smaller pump is no big deal but it might be a big deal for other people. So it's not for everybody but I would encourage as many people as possible to go for it. As far as I'm concerned it's the best thing since sliced bread. The other pro is that with continuous glucose monitoring you're looking at your blood glucose every five minutes of the day and night whether you want to or not, you know the record is there. It's a huge pro because it gives you the opportunity to take more in real-time responsibility for what your results are and make adjustments if you need to so that you can stay as close as possible to normal range, if not within normal range. So the con of that is that the machine sends alarms of low blood glucose and occasional high blood glucose, in my case, 24 hours a day. So you can go to bed, I go to bed late normally, it's normally midnight, but I can have an alarm ringing which says you're going to go low, you're going to go below 4.4 and it will send me that alarm at 1 a.m and then sort of 10 minutes later it will send another one and then another one and then when you take the recovery action and you have your carbohydrate it keeps sending you alarms that you're still low until you go above and I think that's the con in that because it's looking at glucose levels in the interstitial fluid. It's not the same as blood glucose and it has to go through the blood first before it then gets to the tissues. There's a sort of delayed reaction and that's quite frustrating at 3am when you think well you know I've taken the action, I've had my carbs, just leave me alone please. You know it's my life and and you can't turn the alarms off. You can turn most of them off, but the low blood glucose ones you certainly can't and I kind of get it from a lawyer's perspective for the pump manufacturer, but for a daily living perspective, it's a nuisance. And so for me going back to the pros and cons, huge pro has been much better HbA1c levels. I've always been a sort of little high than the preferred kind of, I can't remember what the number is now, but the lowest one I had was two months ago which was 44 and they tend to be about 50 or 53, something like that, so to go down to 44 was great, but the con of that is that I spent a lot of time low, so I was experiencing a lot of hypos, which is why the kind of balance thing is important, because you can have great scores on the doors, but actually are you having the right quality of life is a question, and being low for more than you need to be is not a great quality of life I'd say. Another benefit is that I can eat when I want, don't have to have regular mealtimes again because there's a good combination of bolus doses and basal doses so it's as close to a normal pancreas as I can get for the moment. I like the fact that it's monitoring my glucose levels every five minutes and that's what I think is a significant advantage over the Libra system because you have to actively scan your sensor and you know if you're not in the mood for scanning or indeed you're too low you're not going to know necessarily. So you know I have the information whether I want it or not but I think that's an advantage. And another key one for me is, despite the fact that I'm talking on this video, I'm not someone who kind of advertises the fact that I'm diabetic. I try to be discreet about it because I want to fit in, weirdly. And so the machine size and weight and so on, it's now very easy for me to be discreet about my diabetes. You'd have to be really interested in how I am and what I'm wearing to notice and most people aren't, so that's fine by me. But I think I would encourage everybody who is on insulin to consider it and I know there criteria that need to be met from the NICE guidelines perspective, but I would say based on my experience it's enabled me to get much better control than I was ever able to before.