Friday 18 January 2013

The insulin pump

This blog first appeared on the Diabetes UK website on 18th January 2013


As I mentioned in one of my previous blogs, I'm taking part in a clinical trial.  It's called the REPOSE (Relative Effectiveness of Pumps over MDI and Structured Education) trial and is basically design to determine whether or not insulin pump therapy is more effective at treating adults with T1 diabetes.  The trial splits particpants into two groups, half are randomised to receive an insulin pump and half continue with their daily injection regime.  Everyone then attends a DAFNE course.  You can read more about the trial on the National Institute for Health Research website.

I've been randomised to the pump half of the group and yesterday I spent the afternoon learning how to load operate, fill and attach the pump.  It's currently filled with saline so it gives us chance to get used to wearing the device and having the cannula attached without actually using it to medicate.  It's a Medtronic Paradigm Veo pump which you can find out more about on the Medtronic website

My DAFNE course starts at the end of January and I'll switch over to insulin the night before it starts.  We'll then go through the DAFNE course getting support for the first week before we're left to fly solo.

I wrote in my own blog  before I'd had my hospital visit about how I felt about making the change.  I'm going to discuss my first impressions of having the pump and the "induction" process here.

Firstly there's a LOT to take in.  To get the pump operational, you need to fill a new reservoir, tell the pump to rewind itself (similar to retracting the plunger on a pen), attach the infusion set (i.e. tubing) to the pump and insert the cannula into your stomach.  Of course it's one of those things that will become second nature pretty quickly, but I imagine the first time I try it by myself will take a while.

Secondly, as I alluded to above, there's a lot of stuff needed to make all this work.  The picture below shows you the contents of the goody bag I brough home from the hospital

As you can see, there's a lot more consumables required for a pump than for a pen!

Inserting the cannula was a bit daunting.  As I think I mentioned before, I'm not actually very good with needles and I had a slight flash of wooziness as I was doing it but thankfully that passed.  It's never good to be the one who passes out during the induction!!  I remember having the same feeling the first time I used an insulin pen and now I don't think twice about that.  I think removing the cannula for the first time is probably my last real challenge but as they stay in for 2-3 days at a time, I've not got that far yet!

I don't really notice the pump during the day which surprised me.  I thought I'd be a lot more conscious of the device (currently clipped onto my belt) and the cannula than I actually am.  There's a bout 2 feet of tubing which can be a bit tricky to conceal but it's nothing major.  It was a bit of a broken night's sleep last night but that was to be expected.  I'm going to try running with it tonight and I'm ordering a pouch I can wear to keep it a bit more concealed so I'm less likely to knock it.

Whilst the overall induction process took a lot out of me, I woke up feeling positive about the change.  I've definitely got a steep learning curve ahead of me, but I see it as something to embrace rather than be afraid of.  I'll write a follow up after DAFNE when I've been using the pump to actually control my diabetes and I'll be able to give an appraisal on how well the first week or so has gone.

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