I’m going to be starting a field trial for a Medtronic Enlite insulin pump with Threshold Suspend technology, which is to say, it tests my glucose level every few minutes and shuts off the flow of insulin if the glucose level drops below a certain point. I’ve never used a pump before, and I was wondering if anybody here uses one, or knows about them.
I don’t have the Minimed, but I have one of their competitors. What do you want to know?
On an aside… I don’t get the “suspend on low blood glucose” thing. Insulin takes anywhere from 10-30 minutes after injection to start working, and continues working for 2-4 hours after injection. If you’re low, turning off the insulin right now isn’t going to do anything for you immediately. Indeed, what I would expect is turning it off will end up with you going high in an hour or so. What am I missing?
The idea is for it to be able to turn the flow of insulin off when you’re not tracking the glucose level, such as overnight. Once they get this down, they can work on something that will increase the insulin delivery when your glucose level increases, and then they’ve got an artificial pancreas.
I’m mostly wondering about a day in the life of a pump user… how much of a pain is it to deal with what amounts to a pager that’s attached to your stomach by an umbilical?
Is showering a problem, or changing clothes?
I normally do hot yoga these days, and I’m wondering if an hour in a 90 degree room is going to cause problems with insulin.
I’m assuming karate classes will not work so well, as getting punched in the pump or injection site is going to be problematic. I’ll also be wearing a constant glucose monitor, which is another thing to not want to get hit on.
How often do you have to add insulin to the reservoir?
Well, I have a pump without tubing (the Omnipod), so not all of your questions are relevant to me. But I’ll take a stab.
How much of a pain is it to deal with what amounts to a pager that’s attached to your stomach by an umbilical?
Well, as I said, I don’t have something attached by umbilical. What I do have is a pod stuck to my arm or leg or back. It’s a minor pain, but you get used to it. You re-learn how to move, and move slower than previously because it’s a pain to knock it off. I would imagine something similar happens with tubed pumps; you learn to move so the tubing doesn’t catch on doorknobs and such.
Is showering a problem, or changing clothes?
These two are definitely different for tubed pumps. I’m pretty sure that for a tubed pump, you unhook it for showers. Changing clothes, no clue.
Hot Yoga:
I don’t think 90 degrees is an issue. They say I’m not supposed to wear my pod in a hot tub, which ranges up to 104 degrees or so, but I’ve never had a problem.
Karate:
I’d remove it since you have the option. I don’t, since once the pod is on, it stays there until you change it (every 3 days). I also don’t do karate so it’s not an issue.
How often do you have to add insulin to the reservoir?
This one is very pump-dependent, I have no clue what your pump will require. I change mine every 3 days.
I guess I can sort of see the overnight thing, but I’d still rather get woken up so I can eat something instead of rely on the insulin levels going down. I guess it’s good as a last resort, but I can see it causing more issues than it solves. But it is a first step to an an artificial pancreas, so that’s great!
The Enlite sensor/transmitter is fairly low profile and most folks get used to it pretty quickly. You are not limited to your abdomen for site placement; you can use your arm, butt, thigh, etc., whatever works best for you.
For most people this is not a problem at all. Once the site is in, it is usually very secure (maybe if you have super-oily skin, not so much). Some people feel it has too strong a grip (sometimes not very easy to remove).
I would not subject insulin to 90-degree temps. It becomes less effective at extreme temperatures. You can suspend (disconnect) the pump for up to an hour, usually, without a problem.
Again, I would disconnect if you’re talking full contact karate (sorry, don’t know much about karate :)). Check your BG before - and before the yoga, too - to make sure it is high enough. Pay attention to how you are feeling, maybe check it an hour into a long workout to avoid lows. Maybe eat a snack beforehand.
This varies widely based on your Total Daily Dose of insulin. The MiniMed reservoir holds 300 units. You should change your site every 2-3 days anyway, so just fill with each site change (assuming your TDD is <100).
Good luck!
mmm
ETA: PM me if you like
I’m not diabetic, but I personally know several people who use pumps, and they LOVE LOVE LOVE them. It gives them so much more freedom, and also results in them being in better health because their diabetic control is much, much better.
I thought pumps were supposed to end that! 
Oh, good lord no… I met with my pre-trainer yesterday and I’m going to be testing my blood glucose like nine times a day. Now I just have to get permission from my doctor to go ahead with this.