To Pump or Not to Pump?
I was diagnosed with diabetes at 18, but I was 50 years old when I decided to see a diabetes educator for the first time. That was five years ago, and I wanted to see if I knew everything I could about how to best manage my disease. Despite my personal research, I realized I wasn't completely up to date when a knowledgeable friend asked why I wasn't on Lantus, which would only mean one shot a day.
I took the idea to the educator. "Yes, you could switch to Lantus," she said. "But have you considered going on the pump?" It made sense—I traveled frequently and had an irregular schedule as a consultant. Still, I was managing my diabetes well with four shots daily. Why would I want to be attached to a machine 24 hours a day?
Before I could register my displeasure with her suggestion, my diabetes educator showed me the pump she recommends to her patients. It was, admittedly, smaller than I expected, and not entirely unstylish. My educator raved about the freedom the pump could give me, by taking away the burden of having to make all my day's decisions about food, meals, and exercise when I took my pre-breakfast shot at 7:30 a.m. I began to wonder: Would it release me from the necessity to eat lunch by 1 p.m.? Or to eat at all? Would it help me avoid hypoglycemic episodes, particularly after exercise, with insulin delivery that's moment to moment? And would it give me better control and thus prevent or delay complications?
Then there were the other questions. Do I want a constant visual reminder of my disease? Where on my body could I comfortably wear a pump? What about when I go to a wedding and want to look and feel particularly attractive? And what about sex? If anything could kill the mood, this would seem to be it. Ultimately, how do I weigh my aversion to being attached to a machine against my knowledge that it could also improve my health?
When I left my educator's office, she said, "Think about it." And that's exactly what I'm doing. Since then remarkable things have happened: A tubeless pump hit the market, and companies are even working on a patch-sized pump. It's been five years since my educator said, "Think about it," and I've done a lot of thinking. While my A1Cs are already in the 5s, I know the pump can offer me a certain elegance in my control and fewer lows. So when that patch-sized pump arrives, I plan to be the first one in line.
Riva Greenberg is the author of The ABCs of Loving Yourself With Diabetes. Her book 50 Diabetes Myths That Can Ruin Your Life: and the 50 Diabetes Truths That Can Save It is to be published in August. She lives in Brooklyn, N.Y.