Defense of my trusty pen – by Helen May
As I’ve mentioned before, I was diagnosed with diabetes in 2002. Until then I knew very little about insulin and how to deliver it. To be honest, I still thought syringes were used. So I was very pleased to see my executive-looking, silver pens. These pens have accompanied me everywhere (up mountains, over sea, along cliffs, …) ever since. They have treated me well. Once I got the hang of using them, they helped me maintain an Hb1AC which the diabetes consultants I see are happy with year after year and, in return, I have tried to look after them.
In the last few years, I started to hear about these new fangled devices: insulin pumps. My immediate thoughts were:
• I do fine with my pens, thank you very much
• Eurgh. Why would I want a piece of machinery stuck to my body?
• What happens at airport security when you’re wearing a pump?
• What do you do with the pump during “intimate moments”?
In other words, “No thanks”…
But recently, I have read more any more about pumps: fellow Diabetes UK bloggers are writing about their experiences and recently, the Scottish government has announced investment into providing insulin pumps to children. So I started to question whether my negativity was a sign of me being stuck in my ways and avoiding change: perhaps a pump could provide even better control than can be gained by me and my trusty pens. So I’ve started to research more about them.
Apologies to all pump users reading this: you know all of this (assuming I have it correct): but I will try to explain my thinking to the pump-less community
First, I wanted to know what a pump looks like. Will it restrict what I wear by showing through a close-fitting sweater? I guess size-wise, it’s not too bad: about the size of a mobile phone. Any smaller and it may be too fiddly to use but it’s big enough that you would see it when I go to the gym. So, size is not a reason to avoid a pump. But the rest of the look is … functional. Insulin pumps are not meant to be fashion items although one suggestion is to wear it on your belt: I picture gadget girl with phone, pump, multi-tool, gps, … hanging around my waist amongst my climbing equipment.
Next, how do they work? From what I understand, they use fast acting insulin which is injected constantly to replace my current long-acting basal insulin. This can be adjusted to manage the need for more or less basal during times of illness (more insulin) and exercise or alcohol (less insulin). Then when you eat, you dial a dose to dispatch the extra insulin for food or as a corrective dose.
So if the pump replicates the pens, why do pumps produce better blood glucose control than insulin delivered through a pen? This is a question I have not been able to find an answer that I am satisfied with. Looking at the research done, it is certainly true that there are improvements in control. Some of these have come about with the extra education that goes hand in hand with the introduction of a pump. But I do not believe this would justify the expense of the pump to the NHS: there has to be more.
It is probably easier to dial up more insulin on a pump than it is to get out my pen from the depths of my bag, attach a new needle, dial up and inject. Maybe, that’s all it is: it’s easier and more discrete so we are more likely to do it. Let’s face it, a disciplined syringe user who sterilises before/after every use could probably maintain good control if they were dedicated to the correct usage.
And finally, are there any other advantages? It was a picture on Daisy’s blog, Diabetic Dais, that illuminated me to another advantage of insulin pumps over pens: some months ago, Daisy posted a picture of her pre-pump used sharps containers. I have often wished I could produce less waste from my diabetes. And by being constantly attached, the pump uses far less needles than my trusty pens. I haven’t found any other benefits yet.
I will continue to read and learn about insulin pumps (although I suspect the only way of really learning is by having one) but, today, I think I would rather lift whatever top I want to wear to inject than be restricted to long baggy tops to hide a pump: I’m happy with my executive silver pens who have treated me well for nine years and look as if they still have a good life left in them … unless I’ve missed something.
If so, please tell me, I don’t want to be left behind because I don’t understand.